A series of 15 patients with intractable benign paroxysmal positional vertigo (BPPV) who had fenestration and occlusion of the posterior semicircular canal (FOP) surgery commencing in December 1990 are reported. Follow-up was from 14 to 40 months. All patients reported a cure of their positional vertigo. No patient regretted having the surgery. All patients had a negative Dix-Hallpike test post-operatively and the test remained negative for the duration of follow-up. Eight patients had a mild high frequency sensorineural hearing (SNHL) loss post-operatively which had almost recovered six months later. No patient reported any change in their hearing following surgery. Of the 10 patients who did not have pre-operative tinnitus, six developed tinnitus but it was not considered significant by them. All patients developed mild unsteadiness following surgery which gradually improved with mobilization and physiotherapy if necessary. The operation preserves hearing, is technically straightforward, well-tolerated and effective.