Objective <p>Meniere’s Disease (MD) is a chronic inner ear disorder characterized by recurrent vertigo, fluctuating hearing loss, tinnitus, and aural fullness. While cochlear implantation (CI) is a well-established treatment for profound hearing loss, its potential impact on vestibular symptoms in MD remains underexplored. This study evaluates the clinical and instrumental correlations between CI and the evolution of vestibular symptoms in MD patients.</p> Materials and methods <p>Retrospective study. We conducted a bi-centric retrospective analysis of 13 patients diagnosed with MD who underwent cochlear implantation at two specialized centers. Patients were categorized based on post-implantation vertigo evolution (resolution, improvement, or worsening). Vestibular function was assessed using cervical and ocular vestibular evoked myogenic potentials (cVEMPs, oVEMPs) and video head impulse tests (vHIT).</p> Results <p>Of the 13 patients, 61.5% experienced complete resolution of vertigo symptoms, 23.1% showed improvement, and 15.4% reported worsening symptoms. The best outcomes were observed in patients who underwent a ‘soft’ surgical approach via the round window, with improved vestibular function in several cases. Impedance fluctuations in the cochlear implant electrodes were observed in 71% of cases but did not correlate with vestibular deterioration.</p> Conclusion <p>Cochlear implantation in MD patients may significantly improve vestibular symptoms, even in the absence of labyrinthectomy. These findings suggest that CI could be considered a first-line intervention in MD patients with profound hearing loss, with vestibular deafferentation reserved for refractory cases. In our opinion, further research with larger cohorts is necessary to confirm these findings.</p>