Minoxidil is an FDA-approved topical medication of over-the-counter solutions used to treat androgenetic alopecia and other types of alopecia. It is a relatively safe topical medication used in dermatology clinics to promote hair growth. Minoxidil (2,4-diamino-6 piperidinopyrimidine-3-oxide), the active ingredient available as a solution or gel, is associated with numerous side effects, particularly when percutaneous absorption is increased. A 45-year-old man visited the emergency department with sudden vertigo, which was caused by excessive use of minoxidil solution and scalp irritation, and the symptoms resolved after he washed his hair and stopped using minoxidil. Systemic absorption is likely enhanced when the scalp skin barrier is disrupted, potentiating vasodilatory effects and subsequent vestibular symptoms. This case report highlights vertigo as an underrecognized systemic side effect of topical minoxidil, especially in the setting of impaired skin integrity and excessive use. Clinicians should be aware of this potential side effect and counsel patients on proper application practices..