Dizziness and vertigo are among the most common symptoms occurring in clinical practice. However, the data on the main causes of dizziness and vertigo remain contradictory. We have analyzed the causes of dizziness in 590 outpatients who were referred to the neurologist. The most common causes of vertigo and dizziness in outpatient practice were benign paroxysmal positional vertigo (BPPV) (33.9 %), phobic postural vertigo (PPV) (21.4 %), Ménière’s disease/delayed endolymphatic hydrops (20 %), vestibular neuronitis/labyrinthitis (8.1 %), and vestibular migraine (4.1 %). Stroke as a cause of vertigo or dizziness was diagnosed only in 0.8 % of patients. Peripheral vestibular disorders were the most frequent cause of vertigo and dizziness in all age groups of patients: in patients younger than 45 years they were diagnosed in 57 % and in patients older than 60 years in 63.3 % of cases. PPV was the second most common cause of dizziness in patients younger than 45 years (37.4 %) but was established only in 7.6 % of patients older than 60 years. Most of the causes of vertigo and dizziness can be reliably diagnosed with bedside examination while laboratory investigation can be considered as an important but complementary entity.