Dizziness is a very common symptom in older adults. Its prevalence increases with age, with approximately one-third of elderly people experiencing the symptom. It may be caused by true vertigo, of peripheral or central cause, pre-syncope, disequilibrium or a combination of these. A detailed history and examination are essential in distinguishing common causes. Providing there is no evidence of central vertigo or of a cardiac cause, further investigation is rarely helpful in diagnosis or management. Management of the patient with dizziness should be holistic; it should not only focus on treatment of the underlying cause but also include other elements such as medication and functional review, and the input of allied health professionals as appropriate.