Background- Unilateral Vestibular Hypofunction (UVH) results in significant balance deficits, gait unsteadiness, and a high perception of subjective disability. While traditional Cawthorne-Cooksey exercises are a clinical mainstay relying on habituation, mechanical interventions like sinusoidal support surface translations (SSST) offer a technology-driven, specialized approach to challenging the vestibulo-spinal reflex (VSR) and facilitating sensory re-weighting. Objective- To compare the efficacy of traditional Cawthorne-Cooksey exercises and Sinusoidal Support Surface Translation exercises in patients presenting with unilateral vestibular deficits using the Dizziness Handicap Inventory (DHI) and Berg Balance Scale (BBS). Methods- A prospective, quasi-experimental study was conducted at the JKKMMRF College of Physiotherapy, Komarapalayam, with 20 participants (n = 10 per group) selected via purposive sampling. Group A performed the Cawthorne-Cooksey protocol involving progressive head, eye, and body movements. Group B underwent instrumental rehabilitation via mechanical sinusoidal support surface translations focusing on postural stability and rhythmic perturbations. Both protocols spanned 6 weeks (3 sessions/week). Baseline and post-intervention outcomes were evaluated using the DHI and BBS, and data were analyzed via paired and unpaired t-tests (p < 0.05). Results- Both groups showed significant within-group improvements (p < 0.001) after 6 weeks. However, Group B demonstrated significantly greater post-intervention gains than Group A. Group B achieved a superior post-intervention mean BBS score of 41.0 \\pm 1.89 compared to 32.4 \\pm 3.95 in Group A (p < 0.0001). Subjective handicap on the DHI also reduced more substantially in Group B (34.4 \\pm 6.67) than in Group A (48.2 \\pm 4.81). Conclusion- Sinusoidal support surface translation is a superior clinical intervention compared to Cawthorne-Cooksey exercises, offering more effective outcomes in restoring objective postural stability and mitigating the subjective impact of dizziness in patients with UVH.