Background and Objectives: Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders. It constitutes the most common vestibular disorder in the elderly with vertigo. Purpose of this study to assess the clinical characteristics and treatment outcome of BPPV in elderly patients. Materials and Methods: We reviewed the medical records of 380 patients above age 60 who were treated for BPPV. Collated data of the elderly BPPV patients in terms of involved canals, number of canalith repositioning procedures and their underlying disease were analyzed and compared with the data of national health report in 2008 that represented the general population. Results: Number of BPPV patients was increased along with age. Three hundred and eighty patients (44.9%) of 847 BPPV patients were over 60. Most commonly involved canal was posterior semicircular canal. Lateral semicircular canal was involved much more frequently (46.8%) compared with previous reports. Along the age, involvement of lateral semicircular canal, frequency of multiple canal involvement and cupulolithiasis increased. In patients older than 60, treatment response was worse than younger ages. More canalith reposition procedures were needed in the elderly than younger patients with BPPV. Between patients with BPPV and normal population, no difference was found in prevalence of co‐morbities, such as diabetes, cerebrovascular disease, cardiovascular disease, other otologic disease, and psychiatric disease. Conclusion: We suggest that more careful diagnosis and intervention should be considered in BPPV of old age due to its complicated natures and lower treatment response.