Vestibular neurectomy may be a surgical option for patients with disabling, peripheral vertigo unresponsive to medical therapy. A retrolabyrinthine approach is preferrred if serviceable hearing is present. After a cortical mastoidectomy is performed, an incision is made in the posterior fossa dura permitting access to the cerebellopontine angle. The vestibulocochlear nerve is identified adjacent to the brain stem. A cleavage plane is developed and the vestibular nerve is transected allowing preservation of the cochlear nerve. The procedure is not recommended in cases of central vertigo or bilateral ear disease.