Because inner ear symptoms are common in patients with migraine, we questioned whether benign positional vertigo (BPV) is more common in patients with migraine than in the general population. We reviewed the records of 247 patients seen in our neurotology clinic over the past 5 years with a confirmed diagnosis of BPV. Each patient had the typical history of BPV, and in each case the characteristic torsional vertical positioning nystagmus was identified. All were interviewed regarding migraine symptoms by means of standard International Headache Society criteria. Migraine was 3 times more common in patients with BPV of unknown cause than in those with BPV secondary to trauma or surgical procedures. Most patients were cured with the particle repositioning maneuver, regardless of the cause. Presumably, patients with migraine suffer recurrent damage to the inner ear (due to vasospasm or some other mechanism) that predisposes them to recurrent bouts of BPV.