Abstract: Objective: To investigate the correlation between the hemodynamic parameters of the vertebral-basal artery system and the balance function of patients with benign paroxysmal positional vertigo (BPPV) and the evaluation value of the severity of the disease.Methods: A total of 117 BPPV patients in our hospital from June 2018 to September 2020 were selected as the research objects.The clinical data and hemodynamic parameters of the vertebra-basal artery system peak systolic velocity (PSV), end of diastolic velocity (EDV), mean flow rate (MFV), resistance index (RI), pulsatility index (PI) , balance functionvestibular symptom index (VSI), Berg balance scale (BBS), balance time of timingof patients with different vertigo grades were compared.The correlation between the hemodynamic parameters of the vertebral-basal artery system and the balance function and the evaluation value of the disease severity of BPPV patients were analyzed.Results: With the aggravation of vertigo classification in patients with BPPV, the PSV, EDV, MFV, BBS scores of the vertebral-basal artery system, and timing balance time decreased, and the RI, PI and VSI indexes increased (P＜ 0.05).PSV, EDV, and MFV of the vertebral-basal artery system of BPPV patients were negatively correlated with VSI scores, and positively correlated with BBS scores and the balance time of timing.RI and PI were positively correlated with VSI scores, and negatively correlated with BBS scores and balance time of timing (P＜ 0.05).AUC of patients with BPPV evaluated by hemodynamic parameters of vertebral-basal artery system were more than 0.7.Conclusion: The hemodynamic parameters of the vertebral-basilar artery system are closely related to the balance function of patients with BPPV.Monitoring the changes of the above parameters can assist the clinical judgment of the severity of the disease and guide the formulation of personalized treatment plans.