There is no conclusive evidence on the consequences of smoking during facial palsy treatment, but the principles of facial palsy treatment suggest that smoking may affect facial palsy recovery. Facial palsy includes central facial palsy and peripheral facial palsy. Central facial palsy is caused by brain injury affecting the facial nucleus and facial nerve, and is commonly caused by stroke, brain tumor, and multiple sclerosis. The treatment of central facial palsy mainly focuses on the cause of the disease, such as anti-platelet aggregation, stabilization of atherosclerotic plaques, and anti-tumor. Smoking can aggravate atherosclerosis and cause vasospasm, which can affect the recovery of these diseases. Peripheral facial paralysis is a condition in which the facial nerve is paralyzed by viral infection, cold stimulation, etc., resulting in inflammation and swelling leading to paralysis of the facial muscles. Treatment mainly includes antiviral drugs, glucocorticosteroids, and neurotrophic drugs. Smoking causes lowering of the body’s immunity and vasospasm, which is not conducive to facial nerve recovery. In addition, from a health point of view, smoking has adverse effects on the cardiovascular, respiratory, hematologic, and immune systems. Smoking is not recommended during facial palsy treatment or in daily life.