Benign paroxysmal positional vertigo (BPPV) is a very common vestibular disorder. While often self-limited, BPPV can have a considerable impact on quality of life. Fortunately, understanding the pathophysiology of both canalithiasis and cupulolithiasis has allowed for the development of various repositioning techniques. For a small subset of patients with intractable BPPV, posterior canal occlusion is a safe, straightforward, and highly efficacious procedure.