Objective To investigate the difference of curative effect between 180° rolling method and barbecue method in the treatment of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods A total of 268 patients with HSC-BPPV were randomly divided into two groups to receive manipulative reduction of Barbecue method (n=130) or 180° rolling method (n=138). The curative effects of the two groups were compared. Results There were no significant differences in the first, second and third cure rates between the two groups (P＞0.05). The Dizziness Handicap Inventory (DHI) score differences before and after treatment in both groups were statistically significant (P<0.05). Comparison of DHI scores between the two groups after treatment showed no statistical difference (P>0.05). There was no significant difference in the number of cases with normal canal paresis (CP) value in rotation test between the two groups after cure (P>0.05). Conclusions For patients with HSC-BPPV, the cure rate, DHI score after cure, and the number of cases with normal CP value of rotation test after cure are comparable between 180° rolling method and Barbecue method. And the 180° rolling method is more simple and time saving in clinical practice, which is worthy of promotion.