The vestibulocochlear or eighth cranial nerve (CN VIII) has purely special sensory afferent function. The nerve has two components, the vestibular nerve, that detects head and body motion, and the cochlear nerve that detects sound. The primary receptors that convey information to the vestibular portion of CN VIII are the semicircular canals that detect angular acceleration, and the otolithic organs that detect linear acceleration. The organ of Corti receives auditory signals and conveys its information via the cochlear portion. Processes that affect the receptors or the nerve will cause hearing loss, tinnitus, otalgia, vertigo, oscillopsia, and disequilibrium. In this review, the authors discuss the anatomy of CN VIII, the clinical evaluation of patients with vertigo and hearing loss, and specific disease entities.