A retrospective study of facial nerve paralysis in two tertiary health institutions in Imo State, N igeria over a five-year period is presented. The aim was to address the aetiology and prevalence of facial nerve paralysis. There was a total of 56 cases made up of 36(64.29%) males and 20 (35.71%) females with a male: female ratio of 1.8:1. The ages ranged from 6 to 68years with a peak prevalence occurring in the age group of 21 – 30 years. Left facial nerve was affected in 60.71% of the cases while the right was involved in 39.29%. The commonest cause was Bell’s palsy 20(35.71%) while Road Traffic Accident was responsible for 14 (25.00%). The outcome of the study would be of predictive value in assessment and management of future cases.