Objective To observe the clinical efficacy of Huzhangye capsule (dispelling pathogenic wind and eliminating phlegm, and suppressing hyperactive liver and subsiding yang) combined with manual reduction on benign paroxysmal positional vertigo (BPPV). Methods A total of 70 patients with BPPV were prospectively enrolled and randomly divided into simple manual reduction group (n=35) and Huzhangye capsule combined with manual reduction group (n=35). The physical, emotional and functional status in residual symptoms were assessed by dizziness handicap inventory (DHI) before treatment, 2 weeks and 4 weeks after treatment. Results There were no significant differences in physical, emotional and functional scores, or total score in DHI between the two groups before treatment (all P>0.05). After 2 weeks and 4 weeks of treatment, the physical, emotional and functional scores, and total score in DHI in Huzhangye capsule combined with manual reduction group were significantly lower than those in the manual reduction group (all P<0.01). Conclusion Huzhangye capsule combined with manual reduction is more effective in improving the symptoms of BPPV than manual reduction alone.