High resolution magnetic resonance imaging (MRI) and computed tomography (CT) meanwhile allow a detailed visualization of the anatomical structures of the vestibulo-cochlear system and thereby are becoming more important for the diagnosis of vestibular diseases. But to this day, differential diagnosis in patients with vertigo as the key symptom mainly bases on a detailed evaluation of the patients' history and neurological workup. In several vestibular vertigo syndromes imaging plays no or only an inferior role. Imaging is of importance in the following vestibular diseases: acute vertigo with suspected ischemic infarction of the brainstem or cerebellum; vestibular paroxysmia; perilymph fistula; chronic audio-vestibular deficits probably due to a vestibular schwannoma in MRI, and in post-traumatic vertigo. This article reviews the indication to and the significance of the imaging modalities in the most common vertigo syndromes.