Elderly otolithiasis, also known as benign paroxysmal positional vertigo, is the most common peripheral vestibular disease, with a certain degree of self-limitation, and some patients can recover on their own; patients with obvious symptoms can be reasonably treated with medication, otolith reset, and vestibular rehabilitation training. 1. Drugs: In principle, drugs are not used for treatment of otolithiasis, as they cannot induce otolith reset. However, for patients with dizziness and balance disorders after reset, drugs to improve microcirculation of the inner ear can be given, such as ipratropium, betahistine, and so on. 2. Otolith reset: It is the main treatment for otolithosis in the elderly, and it can be carried out through the Epley method. The method is to change the patient’s head position sequentially, prompting the otolith to move under the effect of gravity and be discharged from the posterior canal. 3. Vestibular rehabilitation training: It is a physical training method to improve the patient’s vestibular function through central adaptation and compensatory mechanism, so as to reduce the sequelae caused by vestibular injury. Therefore, when otolithosis occurs in the elderly, it is necessary to pay attention to the hospital in time, under the guidance of the doctor for reasonable treatment.