BPPV is the most common cause of vertigo of peripheral origin, accounting for nearly 20% of all vestibular complaints. Patients with this condition typically complain of brief episodes of vertigo brought on by head positioning. The specific characteristics of BPPV are critical provocative positioning with the affected ear dependent, rotary nystagmus toward the dependent ear, a brief 1- to 5-second latency prior to onset, limited duration of 10 to 30 seconds, reversal on assuming an upright position, and fatigability of the response. The presence of these findings essentially confirms the diagnosis. The pathophysiology of BPPV is thought to be due to two proposed mechanisms. The first, called canalolithiasis, proposes that the movement of endolymphatic densities or otoconia during positional testing subsequently causes displacement of the cupula of the posterior semicircular canal. The second, called cupulolithiasis, proposes that otoconia are bound into the cupula, the so-called cupulolithiasis, and with position testing the cupula is deflected. The evaluation of patients with suspected BPPV includes a history and an ear, nose, and throat examination. The neurotologic examination should also be performed, including the Dix-Hallpike maneuver. Management of BPPV begins with a careful explanation to the patient of the nature of the illness. Patient should undergo the particle positioning maneuver. In this maneuver, the patient is moved through a sequence of head positions that are thought to cause the movement of the free-floating particles from the posterior canal into the utricle.