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BACKGROUND: Despite the magnitude of dizziness/vertigo in primary health care, prospective studies are scarce, and few studies have focused on vocational consequences. Using the International Classification of Primary Health Care (ICPC), GPs have two alternative diagnoses, H82 (vertiginous syndrome) and N17 (vertigo/dizziness), when issuing sickness certificates to these patients. AIM: To assess the incidence of dizziness/vertigo in long-term sickness absence and to identify sociodemographic and diagnostic predictors for transition into disability pension. DESIGN OF STUDY: Register-based prospective study, 5-year follow-up. SETTING: All individuals in Norway eligible for sickness absence in 1997 (registered employed or unemployed). METHOD: The risk of disability pension was assessed with Cox proportional hazards analysis, with medical and sociodemographic information as independent variables, stratified for sex. RESULTS: Six-hundred and ninety-four women and 326 men were included. Dizziness/vertigo made up 0.9% of long-term sickness absence among women and 0.7% among men. Among both women and men, 41% was certified with H82 and 59% with N17: 23% of women and 24% of men obtained a disability pension. Age was the strongest predictor for obtaining a disability pension. Subjects with only basic education had an almost doubled risk of obtaining a disability pension compared to the highest educational group. Women with H82 had significantly higher risk for obtaining a disability pension than those with N17. The difference increased after adjustment for sociodemographic variables. Sex had no effect when all other variables were controlled for. CONCLUSION: Dizziness/vertigo is an infrequent cause of certified sickness absence, but long-term sickness absentees with dizziness/vertigo have a considerable risk of obtaining a disability pension in the future. [ABSTRACT FROM AUTHOR]