Canal occlusion/plugging is a very effective technique with a low risk to hearing. The series of posterior semicircular canal occlusions described in this review now becomes the largest in the literature to date. It continues to support this procedure as the treatment of choice for intractable benign paroxysmal positional vertigo (BPPV). All 44 operated ears were relieved of BPPV, with one patient having an atypical late recurrence. Of the 40 ears with normal preoperative hearing, one had a delayed (3-month) sudden and permanent profound loss, while one other had a mild (20 dB) loss. Six patients had protracted courses of imbalance and motion sensitivity. Canal plugging has led to several new and innovative developments including the partial labyrinthectomy for difficult-to-access skull base lesions and superior semicircular canal plugging for dehiscence. These new procedures and their development are reviewed in this paper.