Introduction <p>Vertigo and dizziness are common clinical complaints with diverse etiologies. Emerging evidence suggests a complex interaction between gastric dysfunction and vestibular symptoms, indicating a possible gut–brain–vestibular connection. This review was conducted to summarize the current evidence on the role of gastric disorders as potential contributors to vertigo and dizziness.</p> Methods <p>A systematic literature search and narrative synthesis were performed following the PRISMA approach. Fifty highly relevant studies were identified and reviewed to evaluate associations between various gastric disorders and vestibular symptoms.</p> Results <p>Across the selected studies, vertigo and dizziness were frequently reported in patients with gastric conditions such as functional dyspepsia, gastroparesis, Helicobacter pylori infection, and inflammatory bowel disease. Proposed mechanistic pathways include autonomic nervous system dysregulation, neuroimmune interactions, alterations in gut microbiota composition, and convergence of visceral and vestibular processing within brainstem nuclei. Clinical reports also indicate that management of the underlying gastric disorder may lead to improvement in vestibular symptoms.</p> Conclusions <p> A substantial body of literature supports a multifactorial relationship between gastric dysfunction and vertigo, primarily mediated through autonomic and neuroimmune pathways. However, uncertainties remain due to limited randomized controlled trials, inconsistent diagnostic definitions, and the absence of standardized diagnostic criteria. Future research should prioritize validating diagnostic tools, elucidating causal mechanisms, and conducting well-designed clinical trials to establish evidence-based management strategies for gastric-related vertigo.</p>