Aim: To evaluate the role of the video head impulse test (vHIT) in routine otolaryngological practice and to summarize its combined use with other methods. Materials and Methods: The study was conducted in accordance with the PRISMA-ScR guidelines. The literature search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and the Inventis manufacturer’s website using the following keywords: (“video head impulse test” OR vHIT) AND (vestibular OR vertigo OR otolaryngology OR “vestibulo-ocular reflex”), covering the period 2008–2026. Inclusion criteria: original and review articles on the clinical application of vHIT in otorhinolaryngology, combinations with other tests, nosological forms, and subjective scales. Out of 92 sources, 26 publications were selected. Conclusions: The analysis showed that vHIT outperforms clinical HIT due to the detection of latent saccades and subclinical disturbances of the vestibulo-ocular reflex (VOR). The highest diagnostic value is achieved in combination with cVEMP/oVEMP, HRCT of the temporal bones, and caloric testing. vHIT is informative in cases of acute unilateral vestibulopathy, Meniere’s disease, bilateral vestibulopathy, ototoxicity, vestibular schwannoma, and blast-induced vestibulopathy. It is recommended to use vHIT as the primary objective test in standardized algorithms for vestibular diagnosis to improve the accuracy of differential diagnosis, monitor rehabilitation, and standardize clinical practice.