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Objective To evaluate horizontal semicircular canal (HSC) effects according to Ewald's law and nystagmus characteristics of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) in the supine roll test. Methods Patients with HSC-BPPV (n = 72) and healthy subjects (n = 38) were enrolled. Latency, duration, and intensity of nystagmus elicited by supine roll test were recorded using video nystagmography. Results In patients with HSC-BPPV, horizontal nystagmus could be elicited by right/left head position (positional n