Objectives: No study has separately described and analyzed metabolic syndrome in patients with different types of peripheral vestibular vertigo. The present study investigated metabolic syndrome among patients with 4 different types of peripheral vertigo. Methods:A total of 92 patients with 4 types of peripheral vertigo, namely, benign paroxysmal positional vertigo (BPPV, n = 35), vestibular migraine (VM, n = 24), Menière disease (MD, n = 18), and vestibular neuronitis (VN, n = 15), were included in the present study. Otological and neurootological examinations were carefully performed, and waist circumference, serum HDL level, serum triglyceride level, blood pressure and fasting glucose level were used to evaluate metabolic syndrome. In this study, metabolic syndrome was diagnosed according to standards suggested by the AHA/NHLBI ATP III 2005, and abdominal obesity (≥ 90 cm in men and ≥ 85 cm in women for Korean) was diagnosed according to standards set forth by the Korean Society for Study of Obesity. Result:Patients were divided into 2 groups, according to the vestibular function: normal and abnormal. There was no significant difference in the risk of metabolic syndrome between these 2 groups. However, for patients with the 4 different vertigo types, the prevalence of metabolic syndrome (VM = 40.9%, VN = 50%) was significantly higher in the patients with VM or VN than those with BPPV or MD (P < 0.05). Conclusion:Vestibular function is not significantly associated with the risk of metabolic syndrome. Metabolic syndrome is more common in patients with VM or VN than those with BPPV or MD. This may be due to the different mechanisms involved in these 4 types of vertigo, as well as differences in the self-control of the patients against the vertigo.