Otolithiasis is a relatively common otolaryngological disease, clinically referred to as benign paroxysmal positional vertigo. This condition is mainly caused by lesions in the inner ear, vestibule, or semicircular canals. Some patients may recover on their own, but regular follow-ups are needed during the recovery period to monitor changes in the condition. If clinical symptoms are severe and recur frequently, it is recommended to actively seek timely treatment. Currently, manual repositioning therapy is commonly used. However, if manual repositioning therapy is not effective for some patients, mechanical chair repositioning may be an option. Additionally, some patients may need to combine treatment with medications. However, a very small number of patients who do not respond to conservative treatment may need to consider surgery.