Introduction: recurrent vertigo is a common clinical challenge due to overlapping symptoms among vestibular disorders such as vestibular migraine, Ménière’s disease, BPPV, PPPD, and RVS-NOS. Accurate differentiation is essential to guide diagnosis, management, and improve patient outcomes. Objective: to summarize the key clinical features, diagnostic criteria, and differential characteristics that allow clinicians to distinguish vestibular migraine from other common causes of recurrent vertigo, including Ménière’s disease, BPPV, PPPD, and RVS-NOS. Methods: a narrative review was conducted using PubMed and Web of Science (2000–2025), focusing on clinical features and diagnostic criteria of vestibular migraine, Ménière’s disease, BPPV, PPPD, and RVS-NOS. Relevant peer-reviewed articles, consensus documents, and guidelines in English or Spanish were included. Resultados: the analysis highlights significant clinical overlap among vestibular disorders, with distinct diagnostic criteria essential to differentiate conditions such as VM, MD, BPPV, PPPD, and RVS-NOS. Standardized evaluations and targeted diagnostic tools remain crucial for accuracy. Conclusiones: accurate differentiation of vestibular disorders requires standardized criteria and advanced diagnostic approaches. Multidisciplinary strategies and future research on biomarkers will be key to improving patient outcomes.