Despite progress in video-to-audio generation, the field focuses predominantly on mono output, lacking spatial immersion. Existing binaural approaches remain constrained by a two-stage pipeline that first generates mono audio and then performs spatialization, often resulting in error accumulation and spatio-temporal inconsistencies. To address this limitation, we introduce the task of end-to-end binaural spatial audio generation directly from silent video. To support this task, we present the BiAudio dataset, comprising approximately 97K video-binaural audio pairs spanning diverse real-world scenes and camera rotation trajectories, constructed through a semi-automated pipeline. Furthermore, we propose ViSAudio, an end-to-end framework that employs conditional flow matching with a dual-branch audio generation architecture, where two dedicated branches model the audio latent flows. Integrated with a conditional spacetime module, it balances consistency between channels while preserving distinctive spatial characteristics, ensuring precise spatio-temporal alignment between audio and the input video. Comprehensive experiments demonstrate that ViSAudio outperforms existing state-of-the-art methods across both objective metrics and subjective evaluations, generating high-quality binaural audio with spatial immersion that adapts effectively to viewpoint changes, sound-source motion, and diverse acoustic environments. Project website: https://kszpxxzmc.github.io/ViSAudio-project.