The quality of symptoms assessment of patients with acute dizziness adds much to the diagnostic value in the affected patients within the emergency department. Many previous review articles have concentrated on addressing and assessing these approaches in the emergency department, however, there is increasing evidence regarding these concerns that are not adequately reviewed and comprehended. Emergency physicians should be aware of the recent advances in the field because of the critical role they represent in these settings. In the present literature review, we aim to formulate evidence regarding the urgent considerations that should be considered when assessing acute dizziness. The initial step would be to conduct a differential diagnosis to adequately evaluate the underlying etiology and help plan for adequate interventions. Caring for the serious causes is also critical to reduce the potential harm that might result from a misdiagnosis of these conditions and enhance patient outcomes. Our cumulative evidence also shows that conducting a thorough adequate examination is the ideal approach to a proper diagnosis, as reports indicate that imaging modalities and other neurological tests are not favorable in these situations. Providing adequate training episodes about the neurological and physical examination should be a priority to the emergency physicians as they are located within the first line to which patients with acute dizziness is present.The quality of symptoms assessment of patients with acute dizziness adds much to the diagnostic value in the affected patients within the emergency department. Many previous review articles have concentrated on addressing and assessing these approaches in the emergency department, however, there is increasing evidence regarding these concerns that are not adequately reviewed and comprehended. Emergency physicians should be aware of the recent advances in the field because of the critical role they represent in these settings. In the present literature review, we aim to formulate evidence regarding the urgent considerations that should be considered when assessing acute dizziness. The initial step would be to conduct a differential diagnosis to adequately evaluate the underlying etiology and help plan for adequate interventions. Caring for the serious causes is also critical to reduce the potential harm that might result from a misdiagnosis of these conditions and enhance patient outcomes. Our cumulative evidence also shows that conducting a thorough adequate examination is the ideal approach to a proper diagnosis, as reports indicate that imaging modalities and other neurological tests are not favorable in these situations. Providing adequate training episodes about the neurological and physical examination should be a priority to the emergency physicians as they are located within the first line to which patients with acute dizziness is present.