Background: Superior semicircular canal dehiscence syndrome may require surgical intervention for disabling symptoms. Various surgical procedures have been described but there is no consensus on any treatment algorithm. Methods: In this single-centre retrospective study, we report the results of the procedures performed between 2006 and 2019 using the three main surgical approaches, middle fossa approach (MFA), transmastoid approach (TMA) and round window reinforcement (RWR). The outcome on cardinal cochlear and vestibular symptoms, audiometric results and changes in cVEMPs were analysed. The patients were also interviewed 12 months to 13 years post-treatment to establish their overall satisfaction following surgery. Results: 63 patients were divided into three groups: 42 MFA; 12 RWR; 9 TMA. Post-surgical control rates exceeded 80% for the majority of symptoms in the MFA and TMA groups, and ranged from 11.1 to 83.3% for the RWR group. Over 90% of MFA or TMA patients and 60% of the RWR cohort were satisfied overall with their treatment. Hearing thresholds were intact following surgery in the MFA and TMA groups. There was one case of profound post-operative deafness in the RWR group. Discussion: MFA and TMA are both safe and effective techniques in the treatment of disabling SSCD. Since MFA is the more invasive technique, this study suggests that TMA should be proposed as first-line treatment, temporal bone anatomy permitting. RWR outcomes are more random and this option could be offered to patients at risk under general anaesthesia. Key words: Minor syndrome, superior canal dehiscence, hearing loss, vertigo.