Introduction: Vestibular dysfunction is either unilateral or bilateral. These depict similar signs and symptoms. Here patient primarily complains of head movement induced dizziness and imbalance. The present study compared the customized vestibular rehabilitation therapy (VRT) in unilateral and bilateral vestibular lesion patients. Method: The subjects were assigned into two groups by purposive sampling (n=10 each). Group A was Unilateral and group B was Bilateral Vestibular Lesion. Both were given customized vestibular rehabilitation therapy. The twelve days protocol included gaze stability (two mins), dizziness (thirty secs hold, three repetitions) and balance improvement progression exercises (five repetitions each) with thirty secs rest interval in between. Student t test was used for analysis. Patients were evaluated for dizziness and risk of fall using Dizziness Handicap Inventory (DHI) and Fall Efficacy Scale (FES). For the assessment of balance, Tandem Walk, Limit of Stability and Clinical Test of Sensory Interaction on Balance (CTSIB) sub-parameters were evaluated using Balance Master. Result: The vestibular rehabilitation therapy was effective for functional domain of dizziness and FES in both unilateral and bilateral lesion patients. In unilateral lesion patients even physical domain of dizziness, reaction time (RT), end point excursion (EPE) and directional velocity (DCL), sub-parameters of limit of stability and step width, speed, end sway sub-parameters of tandem gait also improved. In bilateral vestibular lesion, only the sway velocity in CTSIB showed improvement. Conclusion: Customized Vestibular Rehabilitation Therapy was effective in improving dizziness and risk of fall greater than balance in unilateral and bilateral vestibular lesion patients.