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左悺于汉桓帝初期只是任小黄门，后来参与桓帝与单超打击外戚梁冀势力的斗争，升上中常侍，封蔡侯。单超死后，宦官五侯的其余四人左悺、唐衡、徐璜、具瑗，权力极大，四处搜括民脂民肥膏。165年，司隶校尉韩演告发左悺的罪行，左悺因此与其兄左称自杀。
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