Otolithiasis, also known as benign paroxysmal positional vertigo, can be diagnosed by symptoms, variability test, audiologic examination, vestibular function test and imaging. 1. Symptoms: Typical symptoms of otolithiasis are sudden and short-lived (usually less than 1 minute) episodes of vertigo accompanied by nystagmus when the head position changes. Vertigo is mostly rotational, with a few floating sensations, and may be accompanied by autonomic symptoms such as nausea and vomiting, but there is no tinnitus, stuffiness in the ears or hearing loss. 2. Dislocation test (1) Dix-Hallpike test: It is used to check the posterior semicircular canal. Methods: Make the patient sit on the examination bed, turn the head 45° to one side, lie down quickly with the help of the examiner, make the head hang over the edge of the bed and become 20° to the horizontal plane, observe for 30 seconds until the nystagmus disappears and then sit up; examine the other side in the same way. Patients with otolithosis will have vertigo and nystagmus when the affected ear is facing down and after sitting up. (2) Rolling test: Used to examine the horizontal semicircular canal. Method: The patient lies on his/her back on the examination bed, turns his/her head rapidly to the left or right, and observes for 1 minute until the nystagmus stops. Patients with otolithiasis will immediately experience vertigo and horizontal nystagmus. 3. Audiological examination: Hearing is usually normal in patients with otolithiasis. 4. Vestibular function tests and imaging tests such as temporal bone and cranial CT and magnetic resonance imaging can be used to explore the cause of otolithiasis. Otolithiasis can be treated by manipulation and repositioning, and it is recommended that patients with otolithiasis should seek timely medical treatment and follow the doctor’s instructions.