Vertigo, defined as an illusion of the movement, always indicates an imbalance within the vestibular system. The same sensation can result from lesions in such diverse locations as the inner ear, the visual-vestibular interaction centers in the brainstem and cerebellum, or the subjective sensation pathways of the thalamus or cortex. Many neuro-otological disease, such as benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, stroke, migraine, phobic postural vertigo etc., can cause vertigo. The peripheral and central causes of vertigo can usually be distinguished based on other features in the history, which are discussed in detail. Research in Vestibular Science 2009;8(2 suppl 1):S7-S15