• A systematic review of 166 RCTs involving 14,718 patients identified 119 distinct outcome measures in TCM treatment for vestibular peripheral vertigo.
• Outcome measures were categorized into 7 domains, with significant heterogeneity and imbalance between endpoint and surrogate indicators.
• Methodological quality of the included RCTs was suboptimal, with lack of standardization in TCM syndrome types and measurement tools.
• The study recommends improving methodological rigor and rational design of outcome measures to enhance the evidence base for TCM in vestibular peripheral vertigo.