At least 50% of patients with dizziness and vertigo are due to peripheral vestibular pathology, i.e., inner ear vestibular pathology in otolaryngology. 20-30% of cases are central vestibular pathology, and some chronic dizziness is associated with medication, psychological, and systemic systemic pathologies. There is a wide variety of lesions involving dizziness, with different manifestations. In terms of the number of episodes, they are divided into single-onset vertigo and recurrent vertigo. The former, such as vestibular neuritis, brainstem and cerebellar lesions, vagal artery infarction, sudden deafness with vertigo, migraine vertigo, benign paroxysmal vertigo and first attacks of Meniere’s disease; the latter include Meniere’s disease, recurrent vestibular disease, vestibular paroxysmal disease, vaginitis, exolymphatic fistula, and pontocerebellar horn tumor. In terms of the duration of the attacks, they are divided into paroxysmal (seconds) and persistent (hours, days, weeks or even prolonged symptoms). The former includes benign paroxysmal positional vertigo, vestibular paroxysms, transient ischemic vertigo, and vestibular dysfunction; the latter includes Meniere’s disease, vestibular neuritis, labyrinthitis, migrainous vertigo, cerebellar and brainstem lesions, and chronic dizziness. The symptoms accompanying the attacks are classified as vertigo with other inner ear symptoms and vertigo without inner ear symptoms. The former includes Meniere’s disease, sudden deafness with vertigo, vagus artery infarction, vaginitis, and exolymphatic fistula; the latter includes vestibular neuritis, vestibular paroxysms, recurrent vestibular disease, benign paroxysmal vertigo, cerebellar and brainstem lesions, migrainous vertigo, and chronic dizziness. From the site of the lesion, it can be divided into peripheral vestibular lesions, central vestibular lesions, systemic lesions and psychosomatic lesions. Peripheral vestibular lesions include vestibular neuritis, benign paroxysmal vertigo, Meniere’s disease, sudden deafness with vertigo, vaginitis, and ectolymphatic fistula. Central vestibular lesions include brainstem and cerebellar lesions, pontocerebellar horn tumors, multiple sclerosis, transient ischemic attack, vagal artery infarction, and migraine vertigo. Systemic lesions include endocrine lesions, cardiovascular lesions, connective tissue lesions, and chronic kidney disease. Psychosomatic lesions include anxiety, depression, and fear. With so many causes, the complexity is somewhat confusing, and the actual clinical situation of the patient is even more complex, often mixed with symptoms of several diseases presenting simultaneously. The diagnosis of vertigo is a great test of the doctor’s knowledge and brain power.