Background Vertigo in paediatric age is not a rare condition. However, a lack of awareness about causes of dizziness in children besides the absence of standard diagnostic workup often leads to unnecessary procedures in managing these cases. The purpose of this cross-sectional study was to determine the prevalence and frequency distribution of balance abnormalities in dizzy children. Additionally, the questionnaire’s utility as a screening tool and its predictive accuracy are discussed. Thus, an organized strategy can be allocated to assist the diagnostic process, which is likely to eliminate unnecessary and costly evaluations. Results This study comprised 848 children who presented with any of the dizzy symptoms referred to the Audio-Vestibular Unit, Fayoum University Hospital. The suggested diagnosis was 23.9% of the cases suffered from otitis media either alone or combined with other diseases, while 17.6% had benign paroxysmal vertigo of childhood. Migraine patients represented 11.2% of the cases. Only 5.5% of subjects had benign paroxysmal positional vertigo. 78.3% of cases with possible diagnosis showed agreement in diagnosis by both paediatric dizziness questionnaire and the final diagnosis reached by a full assessment of the patients. Conclusion Diagnosing dizziness in children is challenging; nevertheless, a structured history taken in conjunction with a vestibular examination is crucial for establishing an accurate diagnosis. The questionnaire appears to be an even-handed tool for diagnosing dizzy children.

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