Fibromyalgia (FM) is a rheumatologic disease that causes pain in the muscles and joints. Some FM patients also notice problems with hearing and balance. In a patient already diagnosed with FM who also has complaints regarding hearing and balance, it is medically reasonable to undertake a screening otovestibular workup to evaluate for more common causes of these symptoms. If no other cause is found, then continued management of FM (by a rheumatologist) is appropriate. In patients with hearing problems, consultation with an audiologist is reasonable. In patients with disequilibrium, a trial of vestibular rehabilitation therapy is reasonable.