Head-shaking nystagmus can be observed in some patients with vestibular lesions. This nystagmus is transient and appears after 15 to 20 cycles of rapid head-shaking. Horizontal head-shaking may be associated with a low-amplitude reversal phase, which follows the primary response. Several previous studies using active head movement have indicated that head-shaking nystagmus is a sensitive indicator of vestibular loss. In this study, the head-shaking nystagmus test using passive head movement was evaluated in 115 patients and 17 control subjects, using three examiners. The data indicate that using passive head movement, the head-shaking nystagmus test is neither sensitive nor specific enough for use as a screening test for vestibular loss.