Surgery for benign paroxysmal positional vertigo (BPPV) has been described in this chapter. Majority of the patients with BPPV can be treated successfully with conservative measures such as canal repositioning exercises and vestibular rehabilitation. However, a small percentage of patients are refractory to conservative treatment and may require surgery. The surgical procedures for BPPV are difficult and are associated with the risk of hearing loss. Therefore, it is extremely important to identify the ideal candidates for BPPV surgery. Patient’s history is the most important tool to determine the cause of persistent symptoms despite conservative therapy. Second, one must confirm the diagnosis of BPPV and, finally, confirm the side that is affected. Surgery is indicated for patients with recurrent and chronic symptoms that are extremely debilitating and warrant an invasive procedure. Surgical procedures for BPPV include singular neurectomy (transection of the posterior ampullary nerve) and posterior semicircular canal occlusion which are discussed in this chapter.