Fluctuating hearing loss and vertigo are the typical presentations of Meniere’s disease. However, it is unusual that fluctuating hearing loss and vertigo are caused by vertebral artery occlusion or cerebral infarction. Here, we described the case of a 54-year-old male patient with hypertension and diabetes mellitus who presented with fluctuating hearing loss in his left ear and severe whirling-type dizziness without associated neurological signs or symptoms. Temporal magnetic resonance imaging (MRI) was normal. He was diagnosed with a possible Meniere’s disease and started conservative treatment. Eight years later, the patient developed dysarthria and left-side weakness. Brain MRI revealed right anterior medullary infarction, and cerebral angiography showed occlusion of the right vertebral artery. In this case, we attempted to review the initial imaging study and reported the characteristics of the case.