OBJECTIVE: Patients with migraine headaches have a high prevalence of episodic vertigo, and several studies support the clinical association of migraine and vertigo. Various tests have been conducted in patients with migrainous vertigo; however, only a few studies have been reported on otolith function. The aim of the present study was to increase the understanding of migrainous vertigo pathophysiology by assessing the sacculocollic pathway in patients with migrainous vertigo using vestibular-evoked myogenic potentials testing (VEMPs). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. SUBJECTS AND METHODS: VEMP testing was performed in 30 patients with migrainous vertigo and 31 healthy volunteers using 90- and 100-dB tone-pip stimuli. We compared hearing, p13 and n23 latency, VEMP asymmetry, and VEMP formation rate between the patient and control groups. RESULTS: No between-group difference was observed in p13 and n23 latency or VEMP asymmetry. The rate of normal VEMP wave formation in both ears was significantly lower in the patient group compared with that of the control group in response to the 90-dB stimulus. Furthermore, VEMP wave formation was absent in both ears at 100 dB in significantly more patients than in control subjects. CONCLUSION: The results indicate that patients with migrainous vertigo show abnormal VEMP findings, suggesting that migrainous vertigo might have a lesion at the sacculocollic pathway.