The results and complications of 224 middle fossa vestibular neurectomies (MFVN) performed between 1968 and 1994 are reported. Relief of vertigo, hearing and tinnitus (both pre- and postoperative), facial paralysis, wound infection, suture dehiscence, cerebrospinal fluid (CSF) leak, meningitis, subdural hematoma, average hospitalization time, and death were evaluated. The procedure was effective against vertigo in Ménière's disease in 100% of the cases with unilateral involvement. The excellent results with regard to relief of vertigo and the acceptable incidence of complications make MFVN one of the most adequate surgical treatments for Ménière's disease.