High intensity signals on T2-weighted magnetic resonance imaging (MRI) of cerebral white matter are common in aged people. A recent study suggests that these lesions increase with risk factors for stroke from arteriolosclerosis. Some investigators have identified a relationship between these white matter lesions and dementia or motor deficits. The clinical significance of these white matter lesions remains unclear. To investigate the relationship between these white matter lesions identified on magnetic resonance imaging and dizziness in elderly patients, we evaluated findings on brain MRI of patients with dizziness (n=108) and patients without dizziness (n=28) aged over 60 years old. Deep white matter hyperintense signals (DWMH) and periventricular hyperintensity (PVH) were graded using a qualitative rating scale (Fazekas et al.). Patients with dizziness, especially originating in the central nervous system, showed significantly more severe white matter lesions (grade 2-3). We suggest that older patients with severe white matter high intensity signals experience dizziness due to vascular insufficiency from arteriolosclerosis.