AbstractObjectiveTo investigate gravity perception disturbance (GPD) in patients with Meniere disease (MD), we classified GPD type based on the results of the head‐tilt perception gain (HTPG) and the head‐upright subjective visual vertical (HU‐SVV) evaluated by the head‐tilt SVV (HT‐SVV) test in patients with unilateral MD.MethodsWe conducted the HT‐SVV test on 115 patients with unilateral MD and 115 healthy controls. Among the 115 patients, the period from the first vertigo episode to the examination (PFVE) was known for 91 patients.ResultsThe HT‐SVV test classified 60.9% and 39.1% of patients with unilateral MD as GPD and non‐GPD, respectively. GPD was classified according to HTPG/HU‐SVV combinations as follows: Type A GPD (21.7%, normal HTPG/abnormal HU‐SVV), Type B GPD (23.5%, abnormal HTPG/normal HU‐SVV), and Type C GPD (15.7%, abnormal HTPG/abnormal HU‐SVV). As the PFVE became longer, patients with non‐GPD and Type A GPD decreased; however, those with Types B and C GPD increased.ConclusionThis study provides novel information on unilateral MD from the perspective of gravity perception by classifying GPD based on the results of the HT‐SVV test. This study's findings suggest that overcompensation for vestibular dysfunction in patients with unilateral MD exhibited by large HTPG abnormalities may be strongly associated with persistent postural‐perceptual dizziness.Level of Evidence3b