We report horizontal canal BPPV (HC-BPPV) on targeting its pathophysiology, horizontal semicircular canal function and prognosis together with a review of the literature. Nineteen patients were classified into 9 with canalolithiasis and 10 cupulolithiasis. Average curative periods were a mean time of 81 days for CP positive patients, and 24 days for those with a normal caloric response. The prognosis of patients with a normal caloric response was significantly better than that of patients with positive CP results. Factor which affect the prognosis of HC-BPPV also involve the effectiveness of physical therapy and the cause of recurrent and prolonged cases.