Vertigo, dizziness, and lightheadedness are a high prevalence in outpatient clinics, a symptom to be exact. Few people in daily life deliberately distinguish between vertigo, dizziness, and lightheadedness, and it is easy for patients to refer to dizziness as vertigo and vertigo as lightheadedness when they visit the clinic. In clinical practice, it is important to distinguish these concepts clearly to avoid misdiagnosis. 1.Vertigo: It is a feeling of instability in the balance of oneself or surrounding objects outside oneself “rotating, moving, shaking, tilting”, and is a symptom of vestibular nervous system dysfunction. 2.Dizziness: There is no feeling of unstable balance of rotation and movement of oneself or external objects, only the feeling of head heavy and light swaying and unstable, not tilting, mostly aggravated when walking and standing. 3. Dizziness: It is a feeling of dizziness and lack of clarity, mostly accompanied by stuffy head and heavy head, often caused by febrile wasting diseases, chronic somatic diseases, emotional and mental diseases, exertion, fatigue, etc. The prevalence of vertigo as a clinical symptom occupies the 2nd-3rd place among outpatients’ complaints, and the prevalence of vertigo is about 4.9%, with the most reported annual incidence in adults being 5%. Many hospitals do not have a specialized vertigo specialist, which leads to patients blindly registering to see a doctor, and many doctors do not have professional knowledge of vertigo and cannot clearly understand where “vertigo” comes from. Vertigo is divided into peripheral vertigo and central vertigo. Most of the peripheral vertigo belongs to otogenic vertigo, which belongs to the scope of otolaryngology, and otogenic vertigo includes benign paroxysmal positional vertigo, Ménière’s disease, vestibular neuritis, etc. Among the peripheral vertigo, about 1/3 of the patients belong to benign paroxysmal positional vertigo, which is commonly called “otolith”, and is an episodic, transient, positional vertigo related to position change. It is episodic, transient, positional vertigo related to position change, and can be cured by repositioning. Meniere’s disease is an idiopathic disease of the inner ear, which is characterized by recurrent episodes of rotational vertigo, fluctuating sensorineural deafness, tinnitus, and dullness, with intermittent periods of no vertigo and persistent tinnitus. Meniere’s disease improves significantly with standardized medication, and those with persistent and frequent symptoms may consider inner ear surgery for significant results. Currently, early treatment of Ménière’s disease is advocated to protect hearing, avoid hearing loss and improve the quality of life. However, there are many kinds of diseases that cause vertigo, mostly otogenic, but it is still necessary to be alert when contacting patients and not to misdiagnose central vertigo as peripheral vertigo. One of the simplest as well as common methods is to observe the patient’s nystagmus, and if there is vertical upward jumping nystagmus or irregular twisting nystagmus, one should be alert and need to improve cranial MRI.