This study aimed to examine the prevalence, incidence, clinical presentation, societal impact, and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general adult population of Germany. A cross-sectional neurological survey was conducted using a two-stage sampling design, screening 4869 participants from the German National Telephone Health Interview Survey 2003 for moderate or severe dizziness or vertigo, followed by validated neurological interviews with 1003 participants. The diagnostic criteria for BPPV included at least five attacks of vestibular vertigo lasting less than 1 minute, without concomitant neurological symptoms, and invariably provoked by typical changes in head position. In a concurrent validation study, BPPV was detected with high specificity (92%) and sensitivity (88%) in a sample of 61 patients from specialized dizziness clinics. The results showed that BPPV accounted for 8% of individuals with moderate or severe dizziness/vertigo. The lifetime prevalence of BPPV was 2.4%, the 1-year prevalence was 1.6%, and the 1-year incidence was 0.6%. The median duration of an episode was 2 weeks. BPPV led to medical consultation, interruption of daily activities, or sick leave in 86% of affected individuals, but only 8% received effective treatment. Multivariate analysis identified age, migraine, hypertension, hyperlipidaemia, and stroke as independent risk factors for BPPV. The study concluded that BPPV is a common vestibular disorder with significant morbidity, psychosocial impact, and medical costs. The findings highlight the need for improved diagnosis and management of BPPV to reduce its impact on patients' lives.This study aimed to examine the prevalence, incidence, clinical presentation, societal impact, and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general adult population of Germany. A cross-sectional neurological survey was conducted using a two-stage sampling design, screening 4869 participants from the German National Telephone Health Interview Survey 2003 for moderate or severe dizziness or vertigo, followed by validated neurological interviews with 1003 participants. The diagnostic criteria for BPPV included at least five attacks of vestibular vertigo lasting less than 1 minute, without concomitant neurological symptoms, and invariably provoked by typical changes in head position. In a concurrent validation study, BPPV was detected with high specificity (92%) and sensitivity (88%) in a sample of 61 patients from specialized dizziness clinics. The results showed that BPPV accounted for 8% of individuals with moderate or severe dizziness/vertigo. The lifetime prevalence of BPPV was 2.4%, the 1-year prevalence was 1.6%, and the 1-year incidence was 0.6%. The median duration of an episode was 2 weeks. BPPV led to medical consultation, interruption of daily activities, or sick leave in 86% of affected individuals, but only 8% received effective treatment. Multivariate analysis identified age, migraine, hypertension, hyperlipidaemia, and stroke as independent risk factors for BPPV. The study concluded that BPPV is a common vestibular disorder with significant morbidity, psychosocial impact, and medical costs. The findings highlight the need for improved diagnosis and management of BPPV to reduce its impact on patients' lives.