As we all know, vertigo is one of the most common symptoms in clinical practice. Its anatomy, physiology and etiology are complex, and the treatment process often involves the basic theories and treatment techniques of multiple disciplines, such as otorhinolaryngology, neurology, and even internal medicine and psychiatry, so we generally find it difficult to diagnose and treat. How to diagnose and treat vertigo scientifically in a primary care hospital, which lacks professional treatment institutions and professional examination equipment? First of all, it is necessary for us to understand the concept and classification of vertigo. We often hear the terms “vertigo, dizziness, lightheadedness” in our life, but in fact they are not the same concept. Vertigo is a sense of rotation, swaying or swinging of oneself or the surrounding scenery, a kind of motion hallucination; dizziness is a sense of instability of oneself; dizziness is a sense of mental unclearness. The pathogenesis of vertigo and dizziness are not quite the same, but sometimes they are two manifestations of the same disease at different times, that is, the same disease can have different manifestations at different times of the disease. There are many ways to classify vertigo, and in our clinical work we are used to classify vertigo into peripheral and central according to the site of the disease, with a relatively higher incidence of the former; dizziness can be both a manifestation of the recovery period of the above-mentioned disease, and can also be caused by psychiatric disorders and certain systemic diseases. Since vertigo is closely related to many clinical disciplines, a common problem at present is that doctors of related disciplines have insufficient theoretical knowledge, first of all in diagnosis, and lack of comprehensiveness when taking medical history, and doctors only know the theoretical knowledge of their own disciplines, but have little knowledge of other disciplines, which leads to one-sided diagnosis, omission of disease, excessive examination, or omission of examination. For example, if a patient with otolithiasis is first seen in neurology, if the doctor is inexperienced or does not consult in detail, he or she often prescribes CT, MRI, MRA, Doppler ultrasound, cervical spine film, and a series of other tests according to his or her own discipline’s treatment model. As a result, the patient was first admitted to hospital for observation and treatment. After one cycle of treatment, the patient failed to improve and started to consult an otolaryngologist, who finally confirmed the diagnosis of otolithiasis and gave a manual reset, and the vertigo disappeared immediately. Although the patient was finally cured, the doctor-patient conflict appeared, which should not have occurred, because the doctor’s lack of knowledge of other disciplines led to unnecessary examination and treatment, causing serious mental and economic burdens to the patient. In addition, if some patients with “central vertigo” are first diagnosed in otorhinolaryngology, doctors are accustomed to treat them from the perspective of their own disciplines and do not give them necessary tests such as cranial CT and MRI until the disease is clearly diagnosed, but instead give them long-term treatment and observation, which leads to serious consequences and doctor-patient disputes. In order to prevent similar incidents, we encourage doctors to continuously expand their theoretical knowledge while implementing a joint consultation or consultation system, provided that the first doctor should roughly classify the etiology of the patients seen, and if the condition is found to be inconsistent with his or her discipline, he or she should immediately organize a consultation to make a clear diagnosis and give scientific treatment as early as possible. The diagnosis of vertigo cannot be made without some necessary examination equipment, but primary hospitals often do not have such medical conditions, so how should we work in this situation? Careful questioning of the patient’s vertigo presentation, precipitating factors, attack characteristics, concomitant symptoms and mode of relief during history taking. These are crucial for the diagnosis of the disease. In the absence of examination equipment, we can do some unaided bedside examinations, such as spontaneous nystagmus, gaze nystagmus, VOR examination (head toss test), eye movements (tracking, sweeping, VOR suppression test), position test, Romberg’s sign examination, in situ step test and postural response to push-pull test. Through history combined with bedside examination, it is basically possible to achieve a definite diagnosis or disciplinary categorization of most vertigo, which greatly reduces the chance of misdiagnosis. If a patient with vertigo cannot be diagnosed for a long time, it is recommended to go to a higher level hospital or a specialized clinic that has the conditions for examination as soon as possible.