Acute facial nerve palsy is a common condition which can bring a patient to the Emergency room. This chapter describes the history to be taken and clinical examination to be performed in patients with suspected upper and lower motor neuron facial palsy. The differential diagnosis of common causes of acute facial palsy is tabulated. The systematic clinical examination of a case of facial palsy to identify the cause and localize the site of lesion is also described. The application of the House-Brackmann classification to document the severity of the palsy is also highlighted. Boxes are provided for ready reference. Investigations that are commonly performed for this condition are described in detail. The management of common causes of facial palsy based on their aetiology is described in detail. The need for surgical management in some cases and the type of surgery to be done is described. The chapter is well illustrated to cover all the common causes of facial palsy. A flow chart on management of acute facial palsy is provided for quick reference.