Vertigo, dizziness and lightheadedness are common clinical symptoms, but many doctors and patients do not correctly interpret their meanings, resulting in long-term confusion and mutual misuse of understanding, and clinical misdiagnosis, misdiagnosis and misdiagnosis of treatment often occur. What is the difference between the three in clinical practice? Vertigo, dizziness and lightheadedness are different in terms of sensory experience. Vertigo is mainly a sensation of spinning and tumbling in a certain direction, also known as motion hallucination; dizziness is mainly a sensation of intermittent shaking and instability in the midst of movement or vision, such as walking, standing, sitting and lying; lightheadedness is mainly a sensation of continuous head dizziness. Dizziness is a sensation of continuous head dizziness or confusion without clarity. The damaged organs of vertigo, dizziness and lightheadedness are different. The damaged organ of vertigo should be the nervous system between the vestibular projection area of the brain and the hemicerebral crest of the inner ear vagus, which is responsible for the balance in subjective body turning movement. When artificial factors such as auto-torsion, semicircular canal examination or some lesions lead to excessive, decreased or bilateral loss of contralateral function and exceed the brain’s ability to regulate, it will cause vertigo attacks with signs and symptoms such as nausea, vomiting, nystagmus, unsteadiness in standing or tipping; the damaged organs of dizziness are the systems related to proprioception, vision, otolesthesia (ellipsoidal sac of the inner ear vagus and balloon), due to the distorted or inconsistent information transmission of these peripheral sensory nerves. The damaged organ of dizziness is the cerebral cortex, which is in charge of higher human activities. The overall weakening of the function of the cerebral cortex caused by various organic and functional diseases or long-term mental work causes a sense of persistent dizziness and lack of clarity. It can be seen that vertigo, dizziness and lightheadedness are three different clinical signs caused by damage to different organs, and if they are not distinguished in the treatment, they will lead to wrong localization of the lesion, and wrong investigation and treatment will often occur. The treatment principles of vertigo, dizziness and lightheadedness are different: vertigo is based on dizziness suppression and promotion of vestibular compensation; lightheadedness is based on strengthening the treatment of etiology and promoting the recovery of neurological function; lightheadedness is based on the correct combination of labor and rest, regularity of life, promotion of brain cell function and drug treatment, reduction of brain load and mental stress. In summary, vertigo, dizziness and lightheadedness are completely different in terms of sensory experience, damaged target organs, pathogenesis and treatment principles. Strengthening the differentiation between the three can help reduce misinvestigation, misdiagnosis and mistreatment, which is conducive to the improvement of therapeutic efficacy.