Anterior canal benign paroxysmal positional vertigo (AC-BPPV) is not a rare condition presented with positional downbeating nystagmus (pDBN). This chapter aims to present a brief discussion on epidemiology, history and clinical findings, differential diagnosis, diagnostic criteria, and treatment for AC-BPPV. The foremost differential diagnosis of AC-BPPV is central positional vertigo. The most restrictive diagnostic criterion of AC-BPPV, including resolution of vertigo and nystagmus after a canalith repositioning procedure as the main point, is the best pragmatic diagnostic criterion. The absence of the torsional component does not rule out AC involvement. Patients with positional vertigo and a negative Dix-Hallpike maneuvers (DHM) or downbeating nystagmus complete the examination with the head-hanging maneuver (HHM) and follow the procedure to treat AC-BPPV.