Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. Objectives: To evaluate the different involvement of the vestibular canals, the physical treatment and the clinical results of the benign paroxysmal positional vertigo. Methods: From 1991 to 2000 at the Vestibular Unit of ENT Department of Siena University, 16550 patients referred to us for vertigo or dizziness: in 2270 a diagnosis of BPPV was made. We analyse the collecting data from 1650 patients, especially regarding the different vestibular involvement, the physical treatment and the clinical outcome. Results: In 118 patients (72%) the posterior semicircular canal was involved. The right one was involved in 737 cases, and the left in 451. In 122 patients (7.4%) it was observed the presence of bilateral involvement. Horizontal nistagmous presented in 228 patients (74.5%), and vertical in 51 patients (25.5%). In 61 patients (3.7%) it was atypical. For the treatment of the BPPV of the posterior canal it was used the Semont maneuver, which was efficient in 857 patients(72.1%). For the treatment of the BPPV of the bilateral posterior canal all the 122 patients, were treated with the sequencial Semont maneuver. In the VPPB of the lateral canal, it was used the obliged position, the Barbecue rotation, and the combinatyion of both. Conclusions: BPPV is the most common cause of dizziness in the Unita de Vestibologia. For immediate diagnosis the characteristics of the nistagmous is typical. If not, it must be excluded a neurological disease. The physical treatment is successful.