Since dizziness can represent many different overlapping sensations and can be caused by different pathophysiologic mechanisms, it is critical that the emergency room physician take a careful history to determine the type of dizziness before proceeding with the diagnostic evaluation. The history provides the direction for both the examination and the diagnostic workup (Table 1). Although this review focuses on the vestibular system, many patients who seek emergency assistance because of dizziness do not have a disorder of the vestibular system.