AbstractObjectiveTo evaluate the effect of vitamin D supplementation on the recurrence rate of benign paroxysmal positional vertigo (BPPV).MethodsA single‐center, prospective, double‐blind, placebo‐controlled, parallel‐group randomized controlled trial was conducted between November 2018 and May 2020. After successful treatment with canalith repositioning maneuvers, patients diagnosed with BPPV were randomized to either the vitamin D (n = 20) or placebo (n = 18) group. Only patients with serum vitamin D levels <20 ng mL⁻¹ were included. The vitamin D group received 7000 IU of vitamin D weekly for a year, while the placebo group received a matching placebo drug. The final endpoint was the BPPV recurrence rate and correlation with serum vitamin D levels after 6 and 12 months in both groups.ResultsAmong 38 patients, 37 were followed up for 6 months and 30 for 12 months. Significantly higher serum vitamin D levels were observed in the vitamin D group compared to the placebo group at both the 6‐month and 1‐year follow‐ups (p < .001 at each timepoint). The recurrence rate was lower in the vitamin D group than in the placebo group after 6 months (p = .008) and 1 year (p = .003).ConclusionVitamin D supplementation, in the absence of calcium, may be beneficial for patients prone to recurrent BPPV episodes, particularly when serum vitamin D levels are suboptimal (PRE20181024‐001, Clinical Research Information Service, South Korea).Level of Evidence1b.