The article outlines a practical medical approach to managing vertigo. It explains the anatomy and physiology of vertigo and describes the neuro-otological examination performed on a patient suspected with vertigo. It characterizes the clinical diseases and differential diagnosis for the most common causes of vertigo including benign paroxysmal positional vertigo, vestibular neuritis, Meniere's disease, bilateral vestibulopathy and vestibular schwannoma/acoustic neuroma.