Vertigo is a common clinical symptom and people often say I have vertigo. In fact, vertigo is not the name of a disease, but only a clinical symptom. There are various causes of vertigo, and otolithiasis is one of the most common. Otolithiasis, also known as benign paroxysmal positional vertigo, is caused by the dislodgement of otoliths from the elliptical capsule of the inner ear, which fall into the semicircular canals, float in the endolymphatic fluid of the semicircular canals, or adhere to the crural cap of the semicircular canals. When the person’s body or head position is changed, the change in the position of the otolith particles results in a relative flow of endolymphatic fluid, which results in the onset of vertigo. When the head is stationary, the endolymphatic fluid flow gradually stops and the vertigo symptoms gradually disappear. In humans, there is one left and one right semicircular canal, divided into anterior, horizontal and posterior semicircular canals, which are basically perpendicular to each other. Otoliths can be dislodged and misplaced into any of the semicircular canals and float in the lymphatic fluid, resulting in positional vertigo called canalithiasis. If the dislodged otolith adheres to the crural cap of the semicircular canals, it is called parietal lithiasis. Otoliths of the posterior and horizontal semicircular canals are the most common, and otoliths of the anterior semicircular canals are rare. The most important manifestations of otolithiasis are: transient vertigo after a change in body or head position, which lasts from a few seconds to several minutes and is often accompanied by nausea, vomiting, sweating, and panic. The dizziness gradually disappears when the head is still, and is usually not accompanied by tinnitus, deafness and other ear symptoms. The most effective treatment for otolithiasis is repositioning. The doctor needs to determine the affected side and the affected semicircular canals through the evoked test, and then reposition the otoliths back to the oval capsule through the corresponding maneuver to achieve the purpose of healing. Commonly used repositioning maneuvers include Epley’s method, Guffion’s method, and Semont’s method.