Focused history-taking and skillful bedside examination remain critical in evaluating patients with vestibular symptoms, including dizziness, vertigo, and imbalance. In this chapter, we guide clinicians in choosing the best and most efficient diagnostic roadmap to reach the correct diagnosis in vestibular patients. We outline the elements of a good history of the dizzy patient, using a flowchart approach to the major diagnostic categories. In turn, this history guides the examination, and we review the key elements of the examination, including six key questions our bedside examination must answer. Throughout the chapter, we ground our approach in the principles of neuroanatomic localization, which in turn informs a corresponding differential diagnosis. We emphasize that the questions we ask and the tests we do are driven by hypotheses. In other words, we are describing the clinical application of the scientific method to the bedside.