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Sound evoked Vestibular Myogenic Evoked Potentials (VEMP) recorded form ipsilateral sternocleidomastoid (SCM) has been used in patients with several vestibular disorders however its cardinal use hasbeen in identifying active from inactive superior canal  dehiscence (SCD) and Meniere_s disease. The use of contralateral VEMP response recorded from the contralateral SCM has not been used routinely. The contralateral VEMP response is mediated via the medial vestibular spinal crossed fibers to the contralateral cervical anterior horn cells which stimulate the contralateral SCM. The purpose of this study is to present ipsi- and contra-lateral VEMP results in normal (n=20) and selected vestibular patients from our current VEMP data base (n=800). VEMP signals were acquired using tone burst clicks (500Hz, 5/sec,110dbHL) and surface electrodes over both SCM (reference to sternal notch) with patients in supine position while actively lifting head up to increase both SCM tone. The analysis focused on the ipsiand contra-lateral biphasic VEMP p13-n23 response. Equal amplitude and latency of ipsi- and contra-lateral p13-n23 responses were present in 95% of normal subjects. Contralateral VEMP was not present in 5% of normal subjects. The contralateral response was delayed or absent in patients with suspected central vestibular dysfunction with positive MRI; demylinating plaques in two patients and Chiari malformation in one patient. VEMP responses were variable (ipsi-) or absent (contra-) in two patients with auditory neuropathy. The contralateral response in SCD patients was present with large amplitude and normal latency. Ipsi- and contra-lateral responses were either absent or with large amplitude and normal latency in Meniere's patients. Ipsi- and contra-lateral VEMP responses were present in 7% of patients with absent or reduced caloric response. In conclusion, the use of both ipsi-and contra-lateral VEMP responses is an important addition to the already established utility of VEMP in clinical Neurotology.