Background Peripheral vestibular vertigo is a common cause of vertigo especially in the elderly. The neutrophil to lymphocyte ratio (NLR) is a rapid and cost-effective inflammatory marker that has been assessed previously in peripheral vestibular disorders. However, its relation to the severity of peripheral vertigo has not been previously investigated. The aim of this study is to assess the levels of NLR in peripheral vestibular vertigo of various severity categories. This was a

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... study at the Wahidin Sudirohusodo Hospital and Hasanuddin University Teaching Hospital in Makassar. The NLR was measured among subjects with periphel vestibular vertigo with severity categorised using the Dizziness Handicap Inventory (DHI) questionnaire. Results A total of 39 participants with peripheral vestibular vertigo were recruited. A statistically significant difference was found (p = 0.002, Kruskal–Wallis ANOVA) between the mean NLR for the mild, moderate, and severe DHI categories were 2.47 ± 1.66, 2.64 ± 0.96, and 5.15 ± 2.59 respectively. Conclusion A significant difference in the NLR was found between the three different vertigo severity groups, wherein NLR values rise with increase in vertigo severity. This warrants further exploration on the role of inflammatory biomarkers in vertigo pathophysiology and clinical assessment.