Using fMRI to explore the changes in resting brain spontaneous activity of patients with chronic unilateral vestibulopathy (CUVP). Methods: We recruited 18 patients with right-sided CUVP to the CUVP group and 18 healthy subjects undergoing routine examination at our hospital during the same time period to the control group. Details of disease history were collected. Videonystagmography and bi-thermal caloric testing were performed. Dizziness handicap inventory (DHI) score for all patients were determined. All subjects were further scanned by fMRI. The fractional amplitude of low frequency fluctuation (fALFF) was calculated and analyzed to determine relationship with patient clinical data. Results: Compared with healthy controls, CUVP patients showed lower fALFF values in the right middle occipital gyrus (X=30, Y=－84, Z=3) and higher fALFF values in the right supplementary motor area (X=9, Y=3, Z=54), and the difference was statistically significant (both P=0.01, FWE-corrected). In CUVP patients, the fALFF values in the right middle occipital gyrus were negatively correlated with DHI score (r=－0.430, P=0.003) but showed no significant correlation with CP score nor course of disease (P=0.833, 0.784). Conclusion: In patients with CUVP, spontaneous brain activity was decreased in the visual cortex and increased in the sensorimotor network. It is inferred that the central dynamic compensation may not be completely involved in the occurrence of CUVP; the visual replacement is insufficient, and there is mainly a dependence on the strengthening of posture control.