AbstractA series of 100 consecutive cases of idiopathic Bell's palsy treated by facial nerve decompression are presented. These procedures were accomplished without injury to the facial nerve, hearing or balance and without the production of a mastoid cavity. One hundred percent normal facial function was the result in 22 patients with normal excitability subjected to facial nerve decompression. Sixty‐eight patients who had surgery after loss of nerve excitability obtained an average of 80 percent return of function with varying degrees of synkinesis in most cases. The decision regarding the nature and timing of treatment should be a subjective one, made after a careful analysis of the available facts and each patient's own circumstance. The availability of a promptly accomplished and precisely performed facial nerve decompression allows every patient to have a minimal risk of permanent facial deformity.