The efficacy and acceptability of trimetazidine (60 mg daily) in the treatment of Meniere's disease were compared with those of betahistine (36 mg daily) during a double-blind study spanning two months. Enrolled in the study were 45 patients (33 treated with trimetazidine, 23 with betahistine) presenting cochlear symptoms (vertigo, tinnitus, hearing loss) compatible with a diagnosis of Meniere's disease. Five patients dropped out of the study (3 in the trimetazidine group did not comply with the therapy and 2 in the betahistine group complained of poor response to the treatment) and were not taken into account in the final analysis, which therefore bore on 40 patients (19 receiving trimetazidine and 21 receiving betahistine). Trimetazidine was found to be significantly more effective than betahistine as far as the overall evolution of the ENT disease was concerned, yielding 79% and 57% improvement rates in each group, respectively (p = 0.027). Complete disappearance of the dizziness attacks was noted in 10 patients out of 19 in the trimetazidine group, versus 5/21 patients in the betahistine group (p = 0.06). There was no statistically significant difference between both treatments, as assessed from other clinical or audiometric criteria. Clinical acceptability was equally excellent in both treatment groups.