Primary cilia are essential components of diverse cellular processes. Many of the requirements can be linked to the apparent signaling function of primary cilia. Recent studies have also uncovered a role for primary cilia in planar cell polarity (PCP) signaling. PCP refers to the coordinated orientation of cells along an axis parallel to the plane of the cell sheet. In vertebrates, the inner ear sensory organs display distinctive forms of PCP. One of the inner ear PCP characteristics is the coordinated positioning of a primary cilium eccentrically in every sensory hair cell within each organ. The inner ear, therefore, provides an opportunity to explore the cellular role of primary cilia in PCP signaling. In this chapter, we will introduce the PCP of the inner ear sensory organs, describe the conserved mechanism underlying the establishment of the planar polarity axis in invertebrates and vertebrates, and highlight a unique requirement for primary cilia in PCP regulation in vertebrates. Additionally, we will discuss a potentially ubiquitous role for cilia in cellular polarization in general.