Background and Purpose. This study explores the effect of vibrotactile biofeedback on gait in 20 patients with bilateral vestibular areflexia using observational gait analysis to score individual balance. Methods.A tilt sensor mounted on the head or trunk is used to detect head or body tilt and activates, via a microprocessor, 12 equally distributed vibrators placed around the waist. Two positions of the tilt sensor were evaluated besides no biofeedback in three different gait velocity tasks (slow/fast tandem gait, normal gait on foam) resulting in nine different randomized conditions. Biofeedback activated versus inactivated was compared. Twenty patients (10 males, 10 females, age 39-77 years) with a bilateral vestibular areflexia or severe bilateral vestibular hyporeflexia, severe balance problems and frequent falls participated in this study. Results.Significant improvements in balance during gait were shown in our patients using biofeedback and sensor on the trunk. Only two patients showed a significant individual gait improvement with the biofeedback system, but in the majority of our patients, it increased confidence and a feeling of balance. Conclusion.This study indicates the feasibility of vibrotactile biofeedback for vestibular rehabilitation and to improve balance during gait. © 2011 John Wiley & Sons, Ltd.