Background: Currently, there is a paucity of research comparing the clinical characteristics and repositioning efficacy between posterior canal-benign paroxysmal positional vertigo-canalolithiasis (PC-BPPV-ca) and posterior canal-benign paroxysmal positional vertigo-cupulolithiasis (PC-BPPV-cu). Aims/objectives: To observe the clinical characteristics and compare the efficacy of repositioning maneuvers between PC-BPPV-ca and PC-BPPV-cu patients. Material and methods: Clinical information of patients was collected. The G-Force BPPV diagnostic apparatus was used to simulate dizziness handicap inventory (DHI) positional test, and the therapeutic effects, DHI, and sentiment indicators of baseline, and 1-week and 1-month treatment were compared. Results: A total of 92 patients were collected, with 46 cases in each group, and PC-BPPV-cu patients were with the longer disease course and have worse sleep quality than that of PC-BPPV-ca patients. Moreover, the PC-BPPV-cu patients had a shorter latency of nystagmus and a greater intensity of nystagmus (p < .05); however, PC-BPPV-ca patients experienced higher proportion of reverse nystagmus. In terms of repositioning efficacy, the PC-BPPV-cu group had poorer initial efficacy compared to the PC-BPPV-ca group (p < .05). Conclusions: PC-BPPV-cu patients exhibit more extended disease duration, diminished sleep quality, and pronounced nystagmus. Additionally, they tend to experience less effective initial repositioning treatments and continue to present with more pronounced residual depressive symptoms.