Vestibular paroxysmia (VP) is a rare disease characterized by short spell episodes of vertigo and cranial nerve symptoms. While it has been reported in Japan as eighth cranial nerve vascular compression syndrome, there are very few reports specifically mentioning VP as a distinct disorder. Herein, we report four patients with VP and four patients with probable VP who visited the outpatient department at our Vertigo and Dizziness Center between November 2020 and April 2022, along with a review of the literature. The predominant characteristic of dizziness in these patients was rotational vertigo, often triggered or exacerbated by specific movements. There were no distinctive eye movement abnormalities, but in all the evaluable patients, we observed signs of neurovascular compression of the eighth cranial nerve. Carbamazepine was effective in all cases of VP, although determining the treatment efficacy proved challenging in cases classified as probable VP. VP can be relatively easily diagnosed based on clinical symptoms, and the favorable treatment outcomes emphasize the importance of early diagnosis.