Vestibular migraine is one of the most common causes of recurrent vertigo affecting almost 3% of the population. It may present at any age with attacks of spontaneous or positional vertigo, head motion-induced and visual vertigo lasting minutes to days. Since headache is often absent during acute attacks, other migraine features such as photophobia, phonophobia, or auras have to be specifically inquired about. The Bárany Society classification of vestibular migraine allows identification of vestibular migraine and probable vestibular migraine based on explicit criteria. The diagnosis of VM is based on recurrent vestibular symptoms, a history of migraine, temporal association of vestibular symptoms with migraine symptoms, and exclusion of other causes. Vestibular symptoms must be of moderate or severe intensity. Attacks may last between 5 min and 72 h. Common triggers include stress, sleep deprivation, and hormonal changes. During acute attacks, one may find central spontaneous or positional nystagmus and, rarely, signs of unilateral vestibular hypofunction. In the interval between attacks, patients may experience persistent sensitivity to visual or self-motion. The neurootological examination is mostly normal at this stage; however, some patients have mild ocular motor abnormalities including persistent positional nystagmus.