Experimental work indicates that the vestibular system participates in autonomic reflexes during body movement and postural changes. However, there are no studies of cardiovascular reflexes during vertigo due to human acute vestibular lesions.We assessed the response to active change of posture and hand immersion in cold water in seven patients with unilateral peripheral vestibular failure (vestibular neuritis) and seven age/sex-matched healthy subjects in acute phase (72 h from vertigo onset) and at 2 weeks of follow-up.During acute phase, patients showed decreased blood pressure response during cold hand test (p < 0.05). Upright stance induced deficient decrease of the respiratory component of heart rate variability (p < 0.05) with lack of increase in low frequency/high frequency (LF/HF) ratio. At 2 weeks of follow-up, these abnormalities improved.Results suggest that acute vestibular lesions can interfere with cardiovascular autonomic responses in humans. This may reflect disruption of normal vestibulo-autonomic reflexes.