Each human ear is divided into three parts: the outer ear, the middle ear and the inner ear, which consists of the cochlea and the vestibule. The vestibule is composed of two fluid-filled, interconnected otolithic organs and three semi-annular hemicerebral canals, which are responsible for perceiving the body’s spatial position and movement status and regulating the body’s balance. Benign paroxysmal positional vertigo (BPPV) is one of the common vertigo disorders. The basic pathology of BPPV is that the otoliths of the inner otoliths are dislodged and ectopic into one of the semicircular canals due to some pathogenic factors, and due to the effect of gravity, the ectopic otoliths swim in the semicircular canals with the change of body position or head position and drive the flow of endolymphatic fluid, which constitutes abnormal stimulation to the semicircular canal receptors, and then BPPV occurs. BPPV is characterized by the following clinical features: the patient complains that it occurs when lying down, sitting up, or turning left or right in bed, or even being restricted to a certain position for a long time, such as resting in the left/right side position only; the vertigo often occurs after a latency period of several seconds in the induced position/head position; the vertigo is accompanied by nystagmus of corresponding intensity, and the intensity of the vertigo and nystagmus are characterized by gradual strength and weakness; the nystagmus of different types of BPPV has its own specificity. The duration of vertigo and nystagmus is short, only a few seconds or tens of seconds, usually not more than 1 minute; repeatedly induced posture-induced vertigo and nystagmus are mostly fatiguing; BPPV is not accompanied by tinnitus and deafness. Head trauma, local inflammation and viral infection, and degeneration of the nerve endings in the inner ear are the main causes, often secondary to vestibular neuritis, vaginitis, and posterior circulation ischemia, etc. Some patients also have primary cases. This disease belongs to the scope of otology consultation. The pathogenesis of BPPV canalithiasis and cupulolithiasis has gained consensus, and the otolith repositioning treatment methods based on this theory, such as Epley (1992) and Semont, have been accepted by otology and neurology. The basic treatment process of otolith repositioning is to first locate the ectopic otolith that causes BPPV, and then to perform special postural movements under the supervision of infrared video nystagmography, which is the most appropriate way to stop the vertigo attack by returning the ectopic otolith to its original position in the semicircular canal. In 2006, the Chinese Academy of Otolaryngology issued the first guideline on “Diagnostic basis and efficacy assessment of benign paroxysmal positional vertigo”, and in 2008, the American Academy of Otolaryngology, Head and Neck Surgery also formulated the clinical guideline on BPPV. In 2008, the American Academy of Otolaryngology, Head and Neck Surgery also established clinical guidelines for the diagnosis and treatment of BPPV. In the past, due to the ineffectiveness of drug treatment for BPPV and the lack of other effective treatment measures, conservative treatment was mainly used in the past, mainly vestibular habituation training, but patients often terminated the treatment training because they could not tolerate the repeatedly induced vertigo during the training. BPPV otolith repositioning treatment is another miracle in the history of human medicine because of its immediate and reliable effect, which is the benefit of BPPV patients. Otolith repositioning, as the most convenient and effective treatment for BPPV, is based on accurate localization of the responsible semicircular canal and otoliths, and needs to be distinguished from general positional vertigo. Therefore, accurate localization of the responsible semicircular canal and otoliths and differentiation from general positional vertigo are the key aspects of successful resetting of BPPV otoliths under the condition of mature otolith resetting technology. One of the long-standing consensus of BPPV treatment is that drugs are ineffective, which is actually an inaccurate conclusion in the past when the etiology of BPPV was unclear. For the different causes of BPPV otolith dislodgement, supportive drug therapy is necessary and justified to prevent or reduce otolith dislodgement and to promote its metabolism and cytosolic absorption, based on the aim of preventing recurrence.