The most common cause of positional vertigo is benign paroxysmal positional vertigo (BPPV). BPPV is characterized by brief recurrent spells of vertigo often brought about by certain head position changes that occur when looking up, turning over in bed, or straightening up after bending over. Its diagnosis relies on a thorough history and physical examination, including Dix-Hallpike maneuver. BPPV usually resolves spontaneously, but treatment of persistent cases with canalolith repositioning maneuvers and exercise therapy has been relatively successful. Those patients with atypical findings or whose symptoms fail to respond to medical therapy and otolith repositioning maneuver, however, require further evaluation to rule out intracranial pathologic conditions. We report here on an unusual case of cerebellar hemangioblatoma showing paroxysmal positional vertigo with a review of the related literature.