Background <p>Despite growing evidence on the effectiveness of vestibular rehabilitation (VR) in several vestibular pathologies, data on its impact in patients with vestibular migraine (VM) remain relatively limited.</p> Aims <p>The aim of this study was to evaluate the effects of VR on balance, dizziness severity, sleep quality and quality of life in patients diagnosed with VM.</p> Methods <p>Forty eight patients diagnosed with VM were randomized into two groups: a control group receiving routine medical treatment and an intervention group receiving medical treatment plus an eight-week structured VR program. Participants were assessed for dizziness severity using a Visual Analog Scale (VAS), for balance using balance tests, for sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and for handicap-related quality of life using the Dizziness Handicap Inventory (DHI), at baseline and at the end of the 8-week treatment.</p> Results <p>A total of 40 VM patients completed the study. The majority of the participants were female (85%). The intervention group showed significant improvements in static and dynamic balance tests, PSQI, dizziness-related DHI, and dizziness severity (VAS) from baseline to post-intervention (<i>p</i> &lt; 0.05), whereas the control group showed no meaningful changes. Repeated measures ANOVA revealed significant group × time interactions across balance, functional mobility (TUG), sleep quality, and dizziness outcomes (<i>p</i> &lt; 0.05), indicating greater improvements in the intervention group compared with controls.</p> Conclusion <p>An eight-week structured VR program combined with routine medical treatment significantly improved balance, reduced dizziness severity and dizziness-related disability, and enhanced sleep quality in patients with VM.</p>