Persistent postural perceptual dizziness (PPPD) is the most common cause of chronic dizziness, often following a peripheral or central vestibular event. Characterised by persistent dizziness and heightened sensitivity to motion and visual stimuli, PPPD is a functional disorder rooted in maladaptive sensory processing rather than structural damage. Psychological responses—such as fear avoidance, balance vigilance, and visual dependency—play a critical role in symptom persistence. Cognitive physiotherapy (CPT), integrating cognitive-behavioural and vestibular rehabilitation approaches, targets these maladaptive beliefs and behaviours. A clearer diagnostic framework and evidence-based treatment strategies are essential to improve outcomes and reduce diagnostic delays in this often misunderstood condition.