Abstract: Objective To explore the effect of flunarizine hydrochloride in the prophylactic treatment of vestibular migraine(VM). Methods Totally 160 patients with VM were randomly divided into control group(treated with betahistine mesylate)and experimental group(treated with flunarizine hydrochloride and betahistine mesylate), with 80 cases in each group. After 3 months of follow-up, the total effective rate, cumulative attack time of vertigo, cumulative attack times of vertigo, vertigo intensity score, cerebral blood flow velocity, sleep quality score, life quality score and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of the experimental group was 95.00%, which was significantly higher than 80.00% of the control group(P<0.05). After treatment, cumulative attack time of vertigo, cumulative attack times of vertigo and vertigo intensity score in the experimental group were significantly better than those in the control group(P<0.05). The sleep quality score of the experimental group was significantly lower than that of the control group(P<0.05), and the life quality score was significantly higher than that of the control group(P<0.05). After treatment, the average blood flow velocities of anterior cerebral artery, middle cerebral artery, posterior cerebral artery and basilar artery in the experimental group were significantly lower than those in the control group(P<0.05). The incidence of adverse - reactions was 8.75% in the control group and 13.75% in the experimental group, and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Flunarizine hydrochloride has a good prophylactic therapeutic effect in the treatment of patients with VM, which can effectively reduce the frequency and intensity of vertigo attack, and the safety is good.