OBJECTIVE: To investigate the impact of Meniere's Disease (MD) on balance and proprioception by utilising multi-frequency Vestibular Evoked Myogenic Potentials (VEMP) to evaluate otolith function. DESIGN: Observational study employing the Otolith Tuning Index (OTI) to quantify vestibular function through analysis of VEMP response rates and tuning ratios. STUDY SAMPLE: A total of 123 participants were included, comprising 94 patients diagnosed with MD and 29 healthy controls. VEMP testing was conducted at frequencies of 500 Hz, 750 Hz, and 1 kHz. RESULTS: Among MD patients, 69% reported imbalance, with severe cases predominating in advanced stages. The non-response rate for oVEMP at 500 Hz was 73.3% on the affected side, associated with unpredictable falls. Significant correlations were observed between cVEMP non-responses and both disease severity ( CONCLUSIONS: The Otolith Tuning Index (OTI) effectively measures otolith dysfunction in MD patients, offering valuable insights to enhance diagnostics, patient management, and treatment planning.