Prickly ash (commonly referring to the bark or berries of Zanthoxylum species) has been used in traditional medicine systems—particularly Traditional Chinese Medicine (TCM)—to address symptoms such as dizziness. In TCM, prickly ash is considered to "invigorate the blood" and "dispel wind," which are underlying concepts used to explain the causes of dizziness and vertigo. It is often included as a component in polyherbal formulas aimed at treating symptoms like dizziness associated with blood stasis, poor circulation, or internal "wind." Historical texts from Chinese medicine mention its use for conditions involving numbness, headaches, and dizziness. However, there is limited scientific evidence to support the efficacy of prickly ash for dizziness specifically. Most available research focuses on other potential effects of the herb, such as its anti-inflammatory or analgesic properties, rather than its effects on vertigo or dizziness. While some bioactive compounds in Zanthoxylum species have shown neuroprotective or circulatory benefits in preclinical studies, these findings have not been directly linked to the treatment of dizziness in high-quality clinical trials. Therefore, the use of prickly ash for dizziness is justified primarily by tradition rather than contemporary scientific validation.