To assess whether the addition of vestibular rehabilitation (VR) could significantly improve the efficacy of Duloxetine in treating persistent postural-perceptual dizziness (PPPD). Methods: A total of 120 patients with PPPD were divided into study group and control group according to treatment method. Both groups were given Duloxetine in the morning with a starting dose of 30 mg/day and an adjustment to 60 mg/day after 1 week. The study group was simultaneously given VR. Treatment was continued for 8 weeks. The Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index scale (PSQI) scores, and adverse reactions were compared between the two groups before and at 4 and 8 weeks of treatment. Results: After 8 weeks of treatment, the HADS-A, HADS-D, and PSQI scores were significantly decreased in both groups (P<0.05). Compared to the control group, the study group had significantly lower HADS-A, HADS-D, and PSQI scores at week 8 (P<0.05). Conclusion: The addition of VR could significantly improve the efficacy of Duloxetine in treating PPPD.