Benign paroxysmal positional vertigo (BPPV) remains the most frequent cause of vertigo. The TRV chair is a mechanical device suited for optimization of managing complex cases of BPPV. Although the use of repositioning devices in the management of BPPV is increasing, no applicable guide for the TRV management of the different BPPV subtypes exists. This article presents the techniques for addressing canalolithiasis and cupulolithiasis in the TRV chair for each affected semicircular canal. In a tertiary referral centre like our unit the TRV chair is an asset in the management of BPPV.