It is not very unusual for the ENT personnel to encounter cases of Meniere’s disease with bilateral ear involvement. As compared to unilateral cases the patient with bilateral in-volvement has more significant morbidity and emotional disturbance, particularly in young individuals. The present ambiguity in aetiol-ogy of the disease process has leaked to the management too and no definitive treatment options are described till date. The medical management at present is successful in con-trolling vertigo in the majority of the patients. But the symptoms of hearing loss and tinnitus are relatively less rehabilitated. The options of management like Aminoglycoside infusion and surgery have a limited role in cases with bilateral involvement and this drastically crip-ples the management protocol. The present review aims to evaluate the efficacy of indi-vidual agents and suggest a beneficial proto-col based on the current literature.