This study compared the anti-vertigo effects of fermented (FGE) and unfermented (UFGE) G. elata ultra-fine powder in terms of behavioral indicators and blood biochemical parameters using a mouse model of motion sickness. Results demonstrated that FGE significantly reduced vertigo response index, prolonged rotarod retention time, and increased free movement distance/frequency. It also decreased the serum levels of 5-hydroxytryptamine (5-HT), acetylcholine (ACH), histamine (His), blood urea nitrogen (BUN), and lactic acid, the effect being more pronounced than that of UFGE. UPLC-Q-Orbitrap MS analysis identified 39 blood-absorbed components, and 6 core bioactive compounds and 53 potential targets for the treatment of vertigo were selected. Network pharmacology revealed that the anti-vertigo mechanism of FGE may be related to the fact that through target proteins including TP53, GRB2, HIF1A, MAPK1, and ESR1, gastrodin, p-hydroxybenzyl alcohol, m-hydroxybenzoic acid, arachidonic acid, 4,4’-methylenediphenol and tricin regulated oxygen homeostasis, alleviated oxidative stress, improved hemorheology, and modulated lipid metabolism.