Objective To investigate the incidence of right-to-left shunt (RLS) of heart in patients with vestibular migraine (VM) using transcranial Doppler (TCD) foaming test. Methods The clinical data of patients with VM who were diagnosed in Shaanxi Provincial People's Hospital from Jun. 2016 to Jan. 2017 were collected, and the volunteers without history of cardiac disease or headache during the same period were included as controls. The incidences of RLS of heart in each group were determined using TCD foaming test, and the relationship between the volume of RLS and the concomitnta symptoms of VM was analyzed. Results A total of 139 VM patients (23 males and 116 females) and 30 volunteers were included in this study. There was no significant difference in the incidence of RLS between the VM and control groups (25.9% vs 23.3%, P>0.05). RLS-positive VM patients had a significantly higher rate of palpitation than those with negative RLS (P<0.05). There was no significant difference in visual aura between RLS-positive and RLS-negative VM patients (P>0.05). The shunt volume of RLS was not related to the age of onset or the duration of VM (P>0.05). Among RLS-positive VM patients, the frequency of vertigo in the small shunt amount group (air slug signal of RLS ≤ 10) was significantly higher than that in the large shunt amount group (air slug signal of RLS>10) (7.35 times per year vs 7.27 times per year, P<0.05). Conclusion There is no significant difference in the incidence of RLS between VM patients and normal population. RLS-positive VM patients with small shunt amount are more likely to experience palpitation, and palpitation is more common in RLS-positive VM patients than in RLS-negative patients.