Along with back pain and headaches, dizziness and vertigo rank high among the symptoms that prompt patients to seek medical attention. Those already at a higher risk of falling due to other neurologic deficits or chronic health conditions are much more vulnerable to the effects of dizziness in the elderly. The inner ear is more commonly linked with vertigo, dizziness, tinnitus, and hearing loss than the central nervous system (CNS). Ménière illness is less common (<1%), although migraine is more common (10%). Migraine sufferers have vertigo, motion sickness, and minor hearing loss in around 40% of cases. Because of this, distinguishing migraine from central inner-ear diseases might be challenging at times. Most people who have vertigo or similar symptoms see a primary care physician. Their responsibilities, as well as those of neurologists in this field, have grown in the last decade. Differentiating peripheral from central dizziness and managing the most frequent disorders in an office setting are the main points of this article’s clinical approach to dizziness. Also included are situations where a specialist in otolaryngology or neuro-otology should be consulted and when specific testing of the ears and vestibular system is necessary.