Despite their importance, the dynamical properties of massive stars remain poorly understood. Rotation is a key driver of internal mixing and angular momentum transport, significantly influencing massive star evolution. However, constraining rotation from spectroscopy is challenging, as spectral lines often exhibit excess broadening beyond rotation. The origin of this additional broadening, typically attributed to large-scale velocity fields and commonly referred to as macroturbulence, remains uncertain and unconstrained. Here, we present a combined analysis of TESS photometry and rapid time-series spectroscopy obtained using the high-resolution ESPRESSO instrument at the Very Large Telescope of the European Southern Observatory for the rapidly rotating and pulsating massive star ζ Oph. Leveraging excellent temporal coverage, our analysis demonstrates that pulsation-induced variability leads to peak-to-peak scatter as large as 88 km s−1 in the observed macroturbulent velocity time series. We also demonstrate that time-averaged macroturbulent velocities are spectral-line-specific and can exceed 100 km s−1. Furthermore, the macroturbulent velocities from shorter integration times are systematically lower than those derived from stacked spectra that mimic the longer exposure times typically needed for fainter stars. These results highlight the role of pulsations in driving variable macroturbulence in massive stars, while also pointing to a potential bias in spectroscopic estimates of macroturbulence for fainter massive stars. ⋆ Based on observations collected at the European Southern Observatory under ESO programme 113.26B9.