Parotid gland surgeries are complex due to the close anatomical relationship between the parotid gland and the facial nerve. The risk of facial nerve injury during these procedures presents significant challenges and can potentially lead to temporary or permanent facial paralysis with substantial cosmetic, functional, and psychological impacts on patients. Intraoperative facial nerve monitoring has emerged as a valuable technique to mitigate these risks, offering real-time feedback to surgeons and enhancing nerve preservation. This chapter provides a comprehensive guide to implementing intraoperative facial nerve monitoring in parotid gland surgery, covering patient preparation, electrode placement, interpretation of monitoring data, and troubleshooting. Additionally, it reviews common issues such as false positives and false negatives, technical problems, and the nuances of facial nerve monitoring during extracapsular dissection. This practical approach to intraoperative facial nerve monitoring is intended to enhance the safety and efficacy of parotid gland surgeries, ultimately improving surgical outcomes.