Head tilt in dogs is a clinical presentation that most veterinarians encounter frequently in practice. When a patient presents for evaluation of a head tilt, it can sometimes be challenging to know the best course of diagnostics to recommend and whether or what primary treatment is warranted. Differentiation of the varied clinical presentations of vestibular disease and how they relate to the generation of a list of differential diagnoses can be extremely helpful in providing appropriate primary care and being able to better predict possible outcomes.