Peripheral facial nerve palsy, known as facial palsy in Chinese medicine, is a condition known to the general public as wind-induced mouth and eye distortion. The history of using acupuncture to treat facial palsy has been at least a thousand years, and its mature treatment experience, rich tools and remarkable effects have made facial palsy one of the most common diseases in acupuncture, and it is emphasized that the earlier the onset of acupuncture, the better the effect. However, in recent years, as an acupuncturist, I often encounter patients with facial palsy who ask the same question: Can facial palsy be treated with acupuncture in the acute stage? Those patients with facial palsy who go to the neurology department will get a clear opinion: facial palsy cannot be treated with acupuncture in the acute stage. Why are the answers given by Chinese and Western doctors for the same disease diametrically opposed? Should acupuncture be used in the acute stage of facial palsy or not? Through communication with neurologists and a review of relevant clinical literature, the author is able to answer this question in order to clear the doubts of many facial palsy patients. Several clinical studies in recent years have come to a clear conclusion: during the acute phase of peripheral facial nerve palsy, if the local stimulation (especially mechanical stimulation such as acupuncture) applied to the affected face is too strong, the patient’s chance of developing facial muscle spasm will increase in the later stage of recovery. To put it more simply:In the acute phase of facial palsy, if acupuncture is too strong a stimulus to the affected face, facial muscle spasm may occur. Based on this conclusion and the fact that Western physicians do not know much about acupuncture therapy, they believe that acupuncture treatment for facial palsy naturally means placing needles on the affected face, so they make the subjective inference that “acupuncture cannot be used during the acute phase of facial palsy”. In fact, acupuncture is a holistic treatment that aims to restore the balance of qi and blood between the upper and lower parts of the body, left and right, and inside and outside. In the treatment of facial palsy, although the disease appears on the face, the main treatment points are the Hegu point on the hand, the Taichong point on the foot, the Sanli point on the lower limb, and the Fengchi and Cataract points on the neck. The acupuncture points far from the head and face have a strong role in unblocking the meridians and blood. On this basis, depending on the specific symptoms, the acupuncture points on the affected side of the face are punctured, pricked, tapped, penetrated, suspended, pressed, and other light or heavy treatments are applied to enhance the efficacy. Therefore, Chinese herbalists, especially acupuncturists, are required to study the scientific research results of modern medicine to improve their clinical treatment, so that the possible side effects can be reduced to the lowest level while taking advantage of the overall treatment of acupuncture and ensuring its efficacy. In the acute period, the distal acupoints with overall therapeutic effect should be used as the main acupuncture points, and if the affected facial acupuncture points are used together, the stimulation amount should be lighter such as milli-needle acupuncture, skin acupuncture, etc. After the acute period, the stimulation amount of the affected facial acupuncture points can be gradually increased according to the needs of the disease, such as acupuncture point penetration or combined with electroacupuncture stimulation, etc. As a Western physician, especially a neurologist, you should know as much as possible about the traditional medicine of the motherland. Simply and arbitrarily asking patients with facial palsy not to have acupuncture during the acute period will cause many patients to lose the best period of treatment and cause regrets in terms of efficacy, which is not in line with the scientific spirit of medical workers.