Facial palsy is a weakness of the muscles of the face. The weakness may be complete with no voluntary movements (paralysis), or incomplete with reduced movements (paresis). The majority of supranuclear facial palsies are caused by strokes, intracranial tumors, or other lesions with obvious neurological defects such as hemiparesis and are directed to other health professionals. Facial nerve weakness is quantified using the House‑Brackmann scale which is tabulated in this chapter. A facial palsy can result in problems with oral competence, eating, and speech. The eye can dry out causing exposure keratitis and loss of vision. The assessment of a patient presenting with facial palsy include symptoms specific to the facial palsy, symptoms of associated otological disease, head and neck, and neurological symptoms. Facial palsy obtains a full audiological assessment including acoustic reflex testing if there are associated auditory symptoms. Bell’s palsy and Ramsay Hunt syndrome are the two commonest causes of acute facial palsy. There are a large number of other causes and presentations, some of which are obvious, e.g. trauma and others more obscure. Types of acute unilateral facial palsy are also discussed in detail.