Some of the causes of otolithiasis are still unclear. In the case of primary otolithiasis, accelerated degeneration of the otoliths, decreased absorption capacity and decreased stability of the otoliths are considered, while some otolithiasis can be secondary to diseases such as vestibular neuritis, and changes in the position of the head can trigger the occurrence of otolithiasis. The cause of most otolithiasis is still unclear. If patients have primary otolithiasis, it may be related to changes in calcium ion metabolism in the body, but there is also a part of otolithiasis secondary to diseases such as vestibular neuritis, migraine, Meniere’s disease, viral labyrinthitis, otosclerosis, and chronic mastoiditis of the middle ear. Additionally patients can suffer from ototoxic medications, post cochlear implant surgery, and head injuries that can lead to otolithic episodes. Otolithiasis attacks are usually triggered by changes in the patient’s head movement position. Otolithiasis may be self-healing, for patients who can not be self-healing can be taken to manipulate the reset, some patients can be taken to the semicircular canal obstruction surgery, posterior pudendal nerve severance surgery treatment if necessary. Patients need to sit down when they feel dizzy to prevent falling. Patients with otolithosis are advised to consult a doctor in time to complete the relevant examinations and standardize the treatment.