A review of the literature on drug therapy for Ménière's disease was made using Medline to search for all publications between January 1978 and September 1998. A total of 152 publications were identified that specifically dealt with medical treatment for Ménière's disease. Only betahistine and diuretics appear to have proven efficacy in double-blind studies on the long-term control of vertigo. No treatment has a proven beneficial effect on hearing levels or on the long-term evolution of the disease. Recent publications have proposed a role for the intratympanic use of medication, mainly aminoglycosides, for control of vertigo. We conclude this review by proposing a strategy for the medical treatment of Ménière's disease.