The treatment of atypical otolithiasis is still based on manipulative repositioning therapy, supplemented by medication and other symptomatic treatment. Typical otolithiasis is characterized by transient vertigo induced by head movement to a particular position, usually lasting from a few seconds to more than ten seconds, accompanied by nystagmus and autonomic symptoms. Atypical otolithiasis may be atypical and easily misdiagnosed as opposed to typical otolithiasis. It is possible that the spontaneous vertigo may last longer and the nystagmus may be less noticeable. Treatment of atypical otolithiasis focuses on making a definitive diagnosis, which requires more experience on the part of the doctor because of the atypical vertigo symptoms, as well as differentiating it from other conditions that cause vertigo, and troubleshooting critical conditions such as central vertigo. The treatment of atypical otolithiasis is still the same as that of typical otolithiasis, which is based on manipulation and repositioning, supplemented by medication and other symptomatic treatments. It is recommended to go to the hospital in time, by the specialist physician to clarify the diagnosis, targeted treatment.