A correlation appears to exist between the expression of the polysialic acid neural cell adhesion molecule (PSA-NCAM) and repair in central nervous system (CNS) diseases. However, the expression of PSA-NCAM in the CNS after peripheral nerve injury remains unclear. This study aimed to evaluate the expression of PSA-NCAM in the ipsilateral nucleus ambiguus (NA) after unilateral recurrent laryngeal nerve (RLN) avulsion. The left RLN of adult Sprague Dawley rats were avulsed. The expression of PSA-NCAM, PSA-NCAM/NeuN, and PSA-NCAM/Tuj1 in the brain stem was investigated using immunohistochemistry. The results were subjected to one-way analysis of variance followed by the Tukey post hoc test for statistical analyses. PSA-NCAM-positive and PSA-NCAM/NeuN and PSA-NCAM/Tuj1 double-labeled positive cells were observed 7 days post injury in the ipsilateral NA. PSA-NCAM/NeuN and PSA-NCAM/Tuj1 double-labeled cells were observed at 21 and 7 days post injury, respectively. PSA-NCAM/NeuN double-labeled cells were also found in the contralateral NA. After unilateral avulsion of the RLN, the expression of PSA-NCAM in the ipsilateral NA was correlated with the proliferation and the differentiation of neural cells. PSA-NCAM expression may be used as a predictor of the initiation of repair in neural cells.