Abstract：Objective：To observe the clinical efficacy of acupuncture combined with repositioning maneuvers and oral administration of Betahistine Hydrochloride Tablets in treating benign paroxysmal positional vertigo（BPPV）of spleen deficiency and fluid retention type. Methods：A total of 110 BPPV patients of spleen deficiency-fluid retention type treated at Xinhui Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January to October 2024 were divided into the control group and the observation group using the random number table method，with 55 cases in each group. Both groups were treated with manipulative reduction and oral administration of Betahistine Hydrochloride Tablets，and the observation group was treated with acupuncture. Both groups were treated for three days and followed up for three months. The traditional Chinese medicine syndrome scores，Vestibular Symptom Index（VSI）scores and Berg Balance Scale（BBS）scores were evaluated before and after treatment，and the clinical efficacy and recurrence rates in the two groups were compared. Results： After three days of treatment， the total effective rate in the observation group was higher than that in the control group，the difference being significant（P＜ 0.05）. The traditional Chinese medicine syndrome scores and VSI scores in the two groups were decreased compared with those before treatment，while the BBS score was increased compared with that before treatment，differences being significant（P＜0.05）. The traditional Chinese medicine syndrome score and VSI score in the observation group were lower than those in the control group，and the BBS score was higher than that in the control group，differences being significant（P＜0.05）. There was no significant difference in the recurrence rates between the two groups（P＞0.05）. Conclusion：Acupuncture combined with repositioning maneuvers and oral administration of Betahistine Hydrochloride Tablets in the treatment of BPPV patients of spleen deficiency and fluid retention type can effectively relieve clinical symptoms， improve vestibular function and balance function， improve curative effect， and reduce the possibility of recurrence.