The irreversible injury of the facial nerve is one of the most frequent and severe sequelae in the microneurosurgery of cerebellopontine angle lesions. For this reason, it has been the subject of multiple repair attempts throughout history. Currently, the preferred microneurosurgical method for facial nerve resuscitation after neurotmesis is side-to-end hypoglossal facial nerve neurorrhaphy. In this chapter, the anatomical foundations of the surgical technique are reviewed, and the steps of the procedure are described. The overall treatment of patients with postsurgical facial paralysis is also reviewed. The indication is neurotmesis or axonotmesis with House–Brackmann grade VI paralysis without functional recovery. Most patients achieve grade House–Brackman III clinical recovery 6 months following neurorrhaphy.