Dizziness is a non-specific symptom that can be described in a variety of ways depending on culture, education, language, and individual experience, so the physician must use structured questioning and appropriate guidance to obtain as accurate a description as possible. If the patient does have difficulty describing the condition, a question-and-answer format is used to help determine this. Since 1972, the medical community has uniformly classified dizziness into four different symptoms: vertigo, presyncope, imbalance, and a feeling of light-headedness. Vertigo is an idiosyncratic symptom that refers to the illusion of motion or hallucination of the presence of surrounding objects or one’s own apparent rotation, and the main cause is vestibular system dysfunction; presyncope is a transient feeling of “imminent loss of consciousness and fainting”, and the main cause is basically similar to syncope; imbalance is mainly a feeling of instability and loss of balance control when standing or walking. It is related to a variety of neurological, medical, and psychiatric diseases; the sensation of lightness of the head and feet is the most nonspecific, with the sensation of floating of the head or body, or floating, and has various etiologies. The division of symptoms in patients with dizziness can be seen that only when the symptoms of vertigo or non-specific dizziness are correctly defined, doctors can carry out diagnosis and differential diagnosis, otherwise errors in the whole direction of diagnosis will occur. Careful consultation: the key to correct diagnosis Several clinical studies have proved that correct history taking is the key to clinical diagnosis. 90% of patients can be identified as having specific or non-specific dizziness through consultation, and the cause of dizziness can be clarified in 70% to 80% of cases. After it is clearly identified as vertigo or non-specific dizziness, the clinical features of vertigo or dizziness must be completely understood. Six aspects should be paid special attention to the consultation of such patients. For patients with non-specific dizziness, special attention should be paid to the patient’s history of systemic diseases (hypertension, diabetes, various heart diseases, postural blood pressure fluctuations, medication use, anemia, thyroid disease, etc.), mental status (depression, anxiety, somatization disorders, etc.) and neurological diseases (profound sensory disorders, ataxia, multisystem degeneration, etc.). By mastering the clinical features of the different dizziness or vertigo mentioned above and by careful history questioning, clinicians can make the correct diagnosis for the majority of patients, which cannot be obtained by any auxiliary examination. Understanding the etiology: the guarantee of correct diagnosis The etiology of dizziness involves multiple systems, so it is required that physicians of all disciplines must have multidisciplinary knowledge and the necessary mastery of multidisciplinary diseases involving vertigo or dizziness to reduce diagnostic errors. Clinicians must be aware of the common causes of dizziness or vertigo and not only of their own specialty. Only by clarifying which diseases are the most common causes of vertigo and which diseases are the most important causes of non-specific dizziness can they maintain a clear diagnostic mind and direction in their busy clinical work, rapidly identify and diagnose diseases, and avoid misdiagnosis, delayed diagnosis and over-examination due to inability to distinguish between common and rare diseases. Comparing the results of domestic and foreign studies, we found that periventricular etiology [including benign paroxysmal positional vertigo (BPPV) and Meniere’s disease] and psychiatric disorder etiology are the most important causes of dizziness, the former being the primary cause of vertigo and the latter being the primary cause of nonspecific dizziness. In our country, the proportion of periventricular and psychiatric disorder etiologies is higher than foreign data, due to the lack of a well-developed general medical system in China, where a large number of patients with BPPV and psychiatric disorder dizziness are not diagnosed in a timely and correct manner, which in turn leads to a higher proportion of their diagnosis in specialized outpatient clinics in tertiary hospitals. Targeted examination: The clinician should perform the necessary physical examination for a correct diagnosis. Although it is not possible to perform a complete physical examination in an outpatient clinic, it is important to perform a targeted examination of vital signs, heart, cerebral nerves, ataxia, deep sensation, and hearing. Dix-Hallpike examination should be performed in patients with vertigo or position-related dizziness; vestibular function and pure tone measurements should be performed in patients with possible peripheral vestibular lesions; neuroimaging should be performed in patients with suspected central vestibular lesions, especially magnetic resonance imaging (MRI) is recommended over CT, which is extremely difficult to detect due to bone interference. Various lesions in the posterior cranial fossa. On the contrary, if clinicians carry out vestibular function or neuroimaging examinations indiscriminately, it will not only fail to help the diagnosis, but also confuse the diagnostic thinking and lead to misdiagnosis. The root cause of many clinical misdiagnoses is over-reliance on ancillary examinations without good questioning and lack of sufficient understanding of the specificity and limitations of various ancillary examinations. Updated knowledge: the source of correct diagnosis Despite the large number of patients with confirmed dizziness and vertigo, there are still a considerable number of patients who have not been correctly diagnosed in time, and some of them are even undiagnosed for a long time. Therefore, on the one hand, clinicians should diagnose the symptoms in a scientific and realistic manner and never make an etiological diagnosis arbitrarily, and on the other hand, they should update their knowledge to improve the diagnosis of dizziness. In recent years, research on the etiology of dizziness has made great progress, and the related concepts and diagnoses have changed significantly, which deserve the attention of doctors in various departments. For example, with the improved understanding of BPPV, its diagnosis rate has increased significantly and it has become the first cause of dizziness. 10 years ago, many doctors in China did not know about BPPV and few doctors diagnosed the disease, but since neurologists have learned to diagnose it, many doctors can diagnose hundreds of cases of BPPV. this does not mean that the disease is prevalent in China, but only reflects our long-standing lack of understanding of the disease.