Abstract: Objective To compare the effcacy and recurrence of simple repositioning treatment and medication therapeutic alliance in treatment of horizontal semicircular canal ridge crest benign paroxysm positional vertigo. Methods Sixty-two patients with horizontal semicircular canal ridge crest benign paroxysm positional vertigo who were diagnosed in Vertigo Clinical Service Air Force General Hospital of PLA by Roll-maneuver test were included in this study. Thirty-two cases in repositioning group (group A) were treated with simple repositioning and the other thirty cases in medication alliance treated group (group B) received simple repositioning treatment plus Alprostadil, Cinepazide and Betahistine Tablets. The curative effects of both groups were analyzed at 7 d and 28 d after treatment, and recurrence was observed after three months. Results After 7 d treatment, the recovery rate of group B was 56.7% with the effciency of 40.0% and useless rate of 3.3%. The recovery rate of group A was 46.9% with the effective power of 50.0% and useless rate of 3.1%. The recovery rate was higher in group B than group A with no statistical difference (P> 0.05), and also no statistic difference was found in total effective rate (P> 0.05). After 28 d treatment, the recovery rate of group B was 96.67% with the effciency of 3.33% and useless rate of 0, and the recovery rate of group A was 78.12% with the effciency of 21.88% and useless rate of 0. The recovery rate was higher in B group and it showed signifcant difference (P< 0.05). In the following three months, the recurrence of group B was 10.0% (n=3) and 31.25% in group A (n=10) which showed statistical difference (P< 0.05). Conclusion The repositioning treatment is a preferred method to cure horizontal semicircular canal ridge crest benign paroxysm positional vertigo, medication therapeutic alliance can elevate the recovery rate, shorten cure time and decrease recurrence rate.