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The prognosis of Meniere's disease varies significantly from patient to patient. There is no cure for the condition, only symptom management. Meniere's disease usually affects only one ear (unilateral) and estimates vary widely (10-50%) regarding the number of people that develop bilateral Meniere's disease. The unaffected ear usually compensates for vestibular function and hearing. Even after hearing loss, the patient may continue to experience aural fullness and tinnitus in the affected ear.

The severity and frequency of vertigo attacks, the final degree of hearing loss, and the extent of functional disability are unpredictable. Approximately 70% of cases respond to standard medical therapy including reduced salt intake, diuretic medications, and medications for symptoms. In 30% of cases, surgical therapy may be needed to control symptoms with varying results. Use of the Meniett device is effective to varying degrees in up to 90% of patients whose vertigo is refractory to medical treatment and is often used before deciding whether to undergo surgery. Many patients experience remissions of varying periods, some lasting years or decades.

Meniere's disease typically runs its course over many years. While acute attacks of vertigo typically increase in frequency for the initial years after onset, eventually they decrease in frequency while hearing deteriorates. In general, vertigo usually resolves, hearing loss remains, and other symptoms, such as tinnitus and aural fullness improve in 60-80% of patients regardless of treatment.