Objectives: The purpose of this study was to identify the clinical characteristics of benign paroxysmal positional vertigo (BPPV) occurring after head trauma by comparing to those of idiopathic BPPV (i-BPPV). Methods:We analyzed retrospectively 820 patients diagnosed with BPPV. Patients were classified into two groups: post-traumatic BPPV (t-BPPV) group the onset of positional vertigo was within 14 days of well-documented head trauma) and i-BPPV (excluding secondary causes) group. We compared the clinical characteristics (age, sex, affected side, onset of symptom duration, and types of BPPV) and treatment outcomes between the two groups. Result:The study included 497 patients with i-BPPV and 56 patients with t-BPPV. There were no differences in age distribution and the affected side. t-BPPV group had greater male preponderance (48%) than i-BPPV group (24%) and longer onset time (10.8 ± 13.4 days) compared to i-BPPV group (6.6 ± 13.6 days, p = 0.028). In addition, t-BPPV group demonstrated higher horizontal canal BPPV / posterior canal BPPV ratio (t-BPPV vs i-BPPV = 0.54 vs 0.20, p = 0.008). Although the treatment outcome did not differ between the two groups (p = 0.127), there was a tendency that the t-BPPV group received a higher number of therapeutic maneuvers until resolution than the i-BPPV group (p = 0.056). Recurrence rate also did not differ (p = 0.125). Conclusion:The clinical features did not differ significantly between the two groups, although t-BPPV demonstrated a tendency of low therapeutic efficacy and high recurrence rates compared to i-BPPV. This information may be helpful for clinicians in counseling and managing patients with t-BPPV.