Abstract: Objective To analyze the clinical characteristics of benign paroxysmal positional vertigo (BPPV) in pilots and summarize its aeromedical identification principles. Methods Clinical data including diagnosis, treatment, and aeromedical identification of 7 BPPV pilots admitted to our hospital from 2000 to 2012 were analyzed. Results Of the 7 pilots with primary BPPV, 5 were diagnosed with posterior semicircular canal BPPV and 2 with lateral semicircular canal BPPV. The shortest and longest course of BPPV was 1 week and over 1 year, respectively. BPPV occurred when the pilots were grounded and did not occur when they were flying. The 7 pilots were positive in postural test and normal in hearing test. Of the 7 pilots who underwent Hallpike caloric test, 6 were normal and 1 abnormal in the right semicircular canal function. The disease was spontaneously recovered in 3 pilots two weeks after its onset and cured in 4 patients after canalith reposition. The short-term (1 week) curative effect assessment showed that the treatment was very effective in 5 pilots, effective in 1 pilot and ineffective in 1 pilot. The long-term (3 months) curative effect assessment showed that the treatment was very effective in 6 pilots and effective in 1 pilot. Of the 7 pilots who were observed for 3-6 months on ground after treatment, 5 were flight qualified, 1 was permanent grounded because of psychological reasons and 1 was permanent grounded due to long-term abnormal vestibular function. Conclusion BPPV is a peripheral vertigo disease which can be completely cured and pilots with it can return to flight as the risk of it-induced disability and its recurrence are relatively small.However, the pilots must undergo an overall assessment of vestibular function before they return to flight. The medical identification of vestibular function should be decided according to the clinical characteristics of the disease in combination with the aircraft species and flight duty. The progress of the disease in pilots should be closely monitored after they are allowed to fly.