In otolithiasis, the treatment of choice is to perform otolith repositioning, which includes both manipulative and instrumental repositioning. If the cause is clear, aggressive treatment is needed. If symptoms persist after repositioning, medication is required. The preferred treatment for otolithiasis is otolith repositioning, which is performed in different ways depending on the type of disease after a systematic examination. No matter what type of repositioning is performed, it is a set of movements, and it is important that the sequence and the position of the patient are correct in order to avoid damage to the cervical spine and head during treatment. Patients who are unable to carry out manipulation or still have vertigo after standardized multiple repositioning can use drugs such as ipecac and betahistine under the guidance of a doctor to help alleviate the symptoms. After the onset of the disease should actively seek medical treatment to improve the examination, a clear diagnosis, follow the doctor’s instructions to standardize the treatment.