Vertigo in children is not uncommon in clinical practice, but there are not many reported cases with a clear diagnosis of otolithic-benign paroxysmal positional vertigo (BPPV), so it is a question worth thinking about how to arrive at a reasonable diagnosis and treatment plan. We would like to share two cases of BPPV in children in the otolaryngology clinic, which were successfully treated for reference and reference only. Family history: The child’s mother and grandmother had vertigo. After admission, the child refused to sit or stand, but was mentally responsive and played as usual when resting in bed. On the day of admission, the child vomited once in the morning and once in the evening. The vomit was not ejected, and the vomit was gastric contents, which was seen when changing position. The child was admitted to the hospital in a state of continuous drowsiness, with a stable temperature and a monitored bradycardia that could be maintained above 60 beats per minute. He reported dizziness after sitting up, which was non-rotational and relieved immediately after lying down. Blood and urine toxicity test was negative, cardiac enzymes and troponin were negative, and there was no significant abnormality in cardiac and abdominal ultrasound. Video EEG was not significantly abnormal. Biochemistry was generally normal. On the same day, he was referred to the vertigo clinic of the Department of Otology of Tong Ren Hospital for consultation. The child was in a wheelchair, conscious, with her head tilted against the back of the chair and her facial expression was painful. After detailed questioning of the patient’s history, it was found that the vertigo attack was closely related to the change of position, and the vertigo attack would be caused by lying down, getting up and turning over to the right side, sometimes accompanied by nausea and vomiting, and would be relieved immediately by returning to the supine position. VNG results: Bilateral horizontal semicircular canal function is reduced. Dix-Hallpike test is positive: vertical upward rotational nystagmus appears in the right suspended head position, and the direction of nystagmus reverses when returning to the sitting position. Pure tone audiometry: normal in both ears Final otologic diagnosis: 1. right posterior hemianopsia (PC-BPPV) 2. vestibular neuronitis 3. mycoplasma infection Treatment measures: 1. vertigo symptoms disappeared after Epley’s manipulation reset, no nystagmus and pathologic reflexes, standing, standing, sitting and rising freely, able to walk and play and communicate normally. 2.Treatment medication: 6mg Bid, azithromycin, anti-infection, discharged from pediatric department after 3 days, no abnormality was seen after the follow-up. Case history 2: The child was 6 years old, a first grade student in elementary school. Complaint: Recurrent episodes of vertigo for 1 week. History: In the past 1 month, he had recurrent episodes of vertigo. Every night when he slept and in the morning when he woke up, he had sudden attacks of vertigo when he turned his head to the left side or turned over, his eyes rotated and he was afraid to open his eyes. Since the onset of the attack, the child was afraid to go to bed every night and could only sit and lie down. Because of poor sleep and fear of recurrence of vertigo, the child was restless every day and could not go to school. When we asked him about his medical history, we found out that he had joined a martial arts class at school before the onset of the disease, and his daily training required him to do 50 forward rolls. The child’s usual body key. On examination, the child was clear and articulate, without spontaneous nystagmus; the external auditory canal was open bilaterally, the tympanic membrane was intact, and no abnormalities were found in the nose and pharynx. The Dix-Hallpike test was positive on the left side. When the head was turned to the left side in the supine position, a vertical upward twisting nystagmus appeared, which lasted for 30 seconds and disappeared afterwards. VNG findings: normal bilateral horizontal semicircular canal function; pure tone audiometry: normal hearing threshold level in both ears. Diagnosis: left posterior semicircular canal otolith (PC-BPPV) Treatment: Epley’s maneuver was adopted to reposition the otolith successfully for 1 time, and the child’s vertigo symptoms disappeared immediately.