Vitiligo is a disease that is characterized by a deficit of functional melanocytes all over the body including the inner ear. To study the effect of the reduction of melanocytes on the audio-vestibular system in patients with vitiligo. Our study included 35 patients with vitiligo (study group) and 35 healthy volunteers (control group). Audiological and vestibular function assessments were performed in all the participants and the results were compared between the two groups. We assessed the auditory function utilizing pure-tone audiometry and the auditory brainstem response, while vestibular function was assessed by the Dizziness Handicap Inventory, the cervical vestibular-evoked myogenic potential (cVEMP), and videonystagmography. Twelve patients with vitiligo showed impairment of the hearing especially in high frequencies in comparison with the control group. Auditory brainstem response wave III and I-III inter-peak latencies were significantly prolonged in the study group relative to the control subjects. On cVEMP testing, waves P13 and N23 were significantly delayed in the study group and the caloric test results showed that five vitiligo patients had unilateral weakness and three patients had bilateral weakness. Vitiligo is a systemic disease that can influence the audio-vestibular system. Screening tests for early detection of audio-vestibular changes in patients with vitiligo are important, as they are more susceptible to oxidative damage of ototoxic medications, noise exposure, and age-related hearing loss.