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Few chief complaints cause more apprehension and dread for emergency physicians than dizziness. It is a common condition seen in the emergency department, is understood poorly, and has potentially malignant etiologies. Dizziness cannot be measured. It can mean different things to different patients and is often difficult to precisely characterize. Unfortunately, it is the ability to obtain a precise history and perform an exacting examination that allows a diagnosis to be made and appropriate treatment instituted. This article examines some of the different causes of dizziness, how they can be differentiated via history and physical examination, and their appropriate treatments and dispositions.