Vitamin D deficiency leads to changes in calcium ion metabolism that may cause otolithiasis. Vitamin D deficiency may induce otolithiasis. Vitamin D deficiency is a condition in which bone health is affected by a lack of vitamin D. The main role of vitamin D is to regulate the metabolism of calcium and phosphorus, and a deficiency affects the metabolism of calcium ions. Otolithiasis is a peripheral vertigo disorder associated with changes in head movement, and changes in calcium ion metabolism in the body may be associated with the development of otolithiasis. In addition, otolithiasis can occur secondary to ear diseases such as viral neuritis, head trauma, otitis media, and Meniere’s disease, and the cause is unknown in some patients. The syndrome is often recurrent and manifests as rotational dizziness or vertigo with nausea and vomiting when the head position changes. Patients with vitamin D deficiency and otolithiasis should seek medical attention in a timely manner and be treated under the guidance of a physician, and should not self-medicate to avoid adverse consequences.