From 1982 to 1987, 20 patients with disabling attacks of vertigo and severe hearing loss due to unilateral Meniere's disease were treated with local intratympanic gentamycin. In 18 patients control of vertiginous attacks was achieved. Hearing deteriorated in 8 patients. In spite of complete control of attacks a disabling ablation type of unsteadiness and dizziness affected 7 patients. Two patients required additional treatment after 5–8 months remission. Intratympanic gentamycin seems to be a less useful method of treating severe unilateral Meniere's disease than previously stated. It is, however, a possible alternative to surgical labyrinthectomy with a fair chance of residual hearing preservation.