Background <p>The current Bárány Society diagnostic criteria for Meniere’s disease (MD) do not include radiological aspects. However, computed tomography (CT), native magnetic resonance imaging (MRI), and time-delayed contrast-enhanced inner ear MRI (iMRI) for visualization of endolymphatic hydrops (ELH) have been used in research for years.</p> Objective <p>The aim of this narrative review is to present the current state of research and provide an outlook on future developments. Furthermore, existing possibilities for quantifying inner ear imaging data are shown.</p> Materials and methods <p>PubMed, MEDLINE, and EuropePMC were used for the literature search.</p> Results <p>Semiquantitative visual evaluation of ELH is increasingly supplemented by more accurate, objective quantification. Morphometric assessment of the vestibular aqueduct (VA) can be used for MM phenotyping, and analyses of contrast agent uptake in the endolymphatic duct located in the VA can help to differentiate between MM and vestibular migraine. Decreased vestibulocochlear nerve diameter can be associated with ELH. Image-based group analyses are currently under development.</p> Conclusion <p>Multimodal inner ear imaging can already contribute to the differential diagnosis of MM and other vestibular disorders. A&#xa0;lack of standardization and limited availability currently prevent its widespread use. In unclear cases, patients should be offered detailed inner ear imaging, both for differential diagnostic and scientific reasons.</p>