Little is known about the evolution of vestibular dysfunction and health-related quality of life in bilateral vestibulopathy patients over time. Furthermore, it is unknown whether etiology influences the evolution. A retrospective study was performed investigating the vestibular function at two different time points during a median follow-up time of 24 months in 97 bilateral vestibulopathy patients. Additionally, to evaluate the quality of life and symptoms, validated questionnaires were analyzed. The sum of the caloric testing on the right side and the gain of the rotatory chair torsion swing test significantly decreased over time (p = 0.020 and p = 0.017, respectively). The left-sided caloric tests remained stable, but the median was already 0°/sec at baseline testing. On the contrary, vHIT gain significantly improved on both sides during follow-up (right: p = 0.003, left: p = 0.000). However, the median differences were not clinically relevant. Only two patients (2%) who improved on caloric testing, failed to reach the criteria for bilateral vestibulopathy at follow-up. Both patients had idiopathic bilateral vestibulopathy. At baseline, these patients did already not comply with the criteria for bilateral vestibulopathy based on the vHIT and/or torsion swing test. There was no significant change in the total DHI, EQ-5D-5 L VAS, or HADS scores. The EQ-5D-5 L index significantly increased (p = 0.034). No significant relationship could be determined between etiology and the evolution of vestibular function, quality of life, and symptoms. In conclusion, in the majority of bilateral vestibulopathy patients, vestibular function, health-related quality of life and symptoms did not show a clinically relevant improvement over time.