Meniere’s disease is generally referred to as Meniere’s disease, which is distinguished from otolithiasis mainly by etiology, presentation, ancillary tests, treatment and prognosis. 1. Etiology: The basic pathologic change of Meniere’s disease is the accumulation of water in the membranous labyrinth. Otolithiasis is a benign paroxysmal positional vertigo caused by otolith dislodgement and other reasons. 2. Manifestations: Meniere’s disease manifests as recurrent rotational vertigo with fluctuating sensorineural hearing loss, tinnitus and ear swelling. Otolithiasis is often characterized by recurrent, transient vertigo triggered by a change in head position, which may be accompanied by nystagmus, and is usually not accompanied by hearing impairment. 3. Auxiliary examination: Meniere’s disease may have abnormal vestibular function, such as abnormal results of dynamic balance function examination; audiological examination shows sensorineural deafness, etc.; high-resolution CT and other imaging examinations may suggest that the membranous labyrinth is fluid. Otolithiasis, on the other hand, often shows abnormalities in positional tests. 4. Treatment and prognosis: The treatment of Meniere’s disease mainly focuses on improving the circulation of the inner ear and relieving the fluid in the labyrinth, with medication such as diazepam and surgical treatment such as hearing preservation surgery. The treatment of otolithosis is mainly based on otolith repositioning treatment. In addition, otolithiasis is self-limiting. If vertigo symptoms occur, it is recommended to actively consult a doctor for a clear diagnosis after a systematic examination, and follow the doctor’s instructions to standardize the diagnosis and treatment.