Importance <p>Auricular acupuncture (AA) regulates the function of systems or organs by stimulating specific regions of the body via efferent pathways in the central areas through the auricle. This case aims to investigate the causes of facial contractions observed during AA.</p> Case presentation <p>A female patient, diagnosed with depression and refusing medication, was referred for AA. She presented to our clinic with a complaint of right-sided facial contraction triggered by high-intensity sound during AA.</p> Conclusions and Relevance <p>After evaluation, a decrease in acoustic reflex thresholds of 0.5 and 1 kHz, along with right-sided facial contractions at the same sound frequencies, were detected. This case offers a new perspective on the neural pathways and connections through the auricle.</p>