Objective: Assess angular vestibular-ocular reflex (VOR) changes after treatment with intratympanic gentamicin (ITG) for Menieres disease (MD) and impact on short-term follow-up.Design: Prospective study.Methods: Patients submitted to ITG for unilateral MD.The gain VOR and the presence of compensatory saccades elicited by rapid head impulses were measured using the video head impulse test (vHIT).Results: The study included 31 subjects (mean age: 59 years).Functional Level Scale (FLS) distributions were 35,5%(FLS3);32,2% (FLS4);and 32,2% (FLS5).Mean follow-up was 21 6 7 months.Multiple injections were needed in nine patients.VOR gain in the treated ear was significantly reduced in all subjects and for all the semicircular canals (paired samples t test;P < 0,05).Gain averages after treatment were 0,61 (superior);0,69 (horizontal);and 0,47 (posterior).A horizontal canal VOR gain superior to 0,80 after treatment was associated with the need for a second gentamicin injection (Chi-square;P =0.003).Gain asymmetry between the symptomatic and asymptomatic ear (GASM) was increased after treatment.The rate of vestibular function reduction was 47,9%;26,0%;and 35,8% for the superior,horizontal,and posterior canals,respectively.According to the receiving operator characteristic curve,the amount of change in GASM must be greater than 7 in order to predict the avoidance of a second procedure (area under the curve[AUC]horizontal canal 50,861)and the amount of vestibular function reduction in the pathologic ear in patients with a controlled disease must be greater than 17,8% (AUC horizontal canal 5 0,843).Conclusions: When evaluated with the vHIT,intratympanic gentamicin changes in VOR seem to foresee short-term control of vertigo attacks.