Benign Paroxysmal Positioning Vertigo is the most prevalent vestibular disease with recurrent vertigo, with 24% of all patient clinic visits with vertigo. 75% of cases are idiopathic, most commonly affecting women in their 50's and 60's. Although treatable through Particle Repositioning Manoeuvres, it is recurrent in many patients with a high impact on Quality of Life. Recent research has shown an association between recurrent BPPV and Otolin-1 levels in peripheral blood. The association between this and disorders of Calcium Metabolism are discussed in the paper, in particular the association with seasonal BPPV, Vitamin D levels, the effect of ageing and Parathyroid hormonal disorders. The presentation includes a case series with discussion of care and outcomes of treatment together with a review of the current literature. A pathway of investigation and management for patients with recurrent BPPV is discussed through blood testing, imaging and management through medical and surgical therapy. As a result of following the protocol discussed, recurrence of BPPV may be limited, improving quality of life for patients and reducing clinic workload through reduced requirement to see and treat patients with recurrent symptoms.