Objective This study aimed to explore the differences in clinical characteristics, hearing, and vestibular function test results between children with vestibular migraine (VMC) and adults with vestibular migraine (VM), in order to provide a reference for the diagnosis and treatment of VMC. Methods We retrospectively analyzed the clinical data of patients diagnosed with VMC and VM in the vertigo specialist clinic from January 2022 to July 2024 and compared the clinical features between the two groups. Results A total of 186 patients were included, comprising 92 patients with VMC (44 boys and 48 girls) with a median age of 10.0 years (range 6.3 to 13.0 years), and 94 adult patients with VM (23 males and 71 females) with a median age of 52.0 years (range 35.0 to 61.3 years). The proportion of males in the VMC group was significantly higher than that in the adult VM group (P<0.01). A significant majority of VMC patients (84.8%) had a clear family history and 81.5% had a unique personal history, both of which were significantly higher than in adult VM patients (57.4% and 63.8%, P<0.01). The abnormal rates of auditory function, positive rate of head shaking nystagmus, abnormal rate of CP value in the temperature test, and abnormal rates of cervical vestibular evoked myogenic potential and video head impulse test in VMC patients were all lower than those in VM patients, with statistically significant differences between the groups (P<0.05). Conclusions There was no significant gender difference in VMC patients, whereas adult VM patients were predominantly female. VMC patients often have a significant personal and family history. Auditory vestibular dysfunction can also occur in VMC patients, but the severity is less than in adult VM patients.