Dizziness and vertigo present in patients of all ages. Particularly in older patients, dizziness is associated with a variety of cardiovascular, neurosensory, and psychiatric conditions and with the use of multiple medications. For the patient, the symptoms can be debilitating. In patients older than 60 years, 20% have experienced dizziness severe enough to affect their daily activities. Appropriate diagnosis and treatment can significantly improve quality of life. Most causes of dizziness are benign, but early recognition of serious or life-threatening disease is important. Management of these patients includes referral for neuroimaging and further evaluation in an emergency department.