A review of the literature on selective vestibular neurectomy for Meniere's disease is presented. The procedure is placed in historical context and current refinements of the technique are highlighted. In particular, the different methods of evaluating results on vertigo, hearing, tinnitus, aural pressure and imbalance are summarised. The controversy over the indication, timing and outcome measures for selective vestibular neurectomy is discussed. In experienced hands there appears to be a low complication rate, emphasising the value of this procedure in relieving intractable vertigo when a destructive procedure is indicated.