Evaluation of the dizzy patient can be challenging. A plethora of tests are at the clinician’s disposal. Due to the multitude of subspecialty physicians and evaluation techniques available, the increased risk of high utilization and high cost must be considered. This chapter reviews the basics of cost-effectiveness in medicine and then examines the latest pertinent literature and expert opinions to study cost-effectiveness of the vestibular patient. Considerations are given to the dizzy patient in the both the acute care setting and the otolaryngology/neurotology clinic. Finally, the increasing role of imaging modalities is discussed.