목적: Studies about benign paroxysmal positional vertigo (BPPV) using the video head impulse test (vHIT) are insufficient, and their results are controversial. In this study, gain in the vestibulo-ocular reflex (VOR) of vHIT in patients with BPPV was analyzed. 방법:Patients with BPPV who underwent vHIT from January 2019 to August 2022 were included in this study retrospectively. VOR gains of vHIT were compared between ipsilesional and contralesional semicircular canals. 결과:A total of 78 patients with BPPV was enrolled. For the involved semicircular canal, 51 cases involved the posterior semicircular canal, while 18 patients had lateral semicircular canal canalolithiasis, and nine had lateral semicircular canal cupulolithiasis. In total, the VOR gain in the ipsilesional semicircular canal (0.99 ± 0.20) was lower than that in the contralesional semicircular canal (1.04 ± 0.24) (P = 0.069). For posterior semicircular canal BPPV, the VOR gain in the ipsilesional semicircular canal (0.96 ± 0.21) was significantly lower than that in the contralesional semicircular canal (1.04 ± 0.27) (P = 0.042). For lateral semicircular canal canalolithiasis and cupulolithiasis BPPV, there were no significant differences in VOR gain between the ipsilesional (1.09 ± 0.13 and 0.97 ± 0.16, respectively) and contralesional semicircular canals (1.06 ± 0.19 and 1.00 ± 0.14, respectively) (P = 0.679 and 0.374, respectively). 결론:The VOR gains of vHIT in the ipsilesional semicircular canals were within normal limit in patients with BPPV. However, the VOR gain in the ipsilesional semicircular canal was significantly lower than that in the contralesional semicircular canal in patients with posterior semicircular canal BPPV.