Persistent Postural-Perceptual Dizziness (PPPD) is a multifaceted and incapacitating disorder characterized by persistent dizziness and instability. Vestibular rehabilitation has arisen as a promising therapeutic strategy, aiming to mitigate symptoms and enhance patients' overall well-being. However, this therapy is not without its set of challenges and controversies. This narrative review delves into Vestibular Rehabilitation in Patients with Persistent Postural-Perceptual Dizziness (PPPD), revealing several pivotal themes. The challenges associated with diagnosing PPPD, its inherent heterogeneity, and the often-intertwined psychological aspects add complexity to treatment decisions. Despite these obstacles and ongoing debates, vestibular rehabilitation stands as a promising therapeutic path, underscoring the significance of continuous research and individualized care in the management of this intricate and debilitating condition.