OBJECTIVE: To observe the efficacy of ultrasound drug penetration in the acute phase of treatment of patients with Bell’s palsy. Methods: 80 patients with Bell’s palsy were randomly divided into two groups of 40 cases each, and the conventional treatment group was given oral prednisone, acyclovir, intramuscular vitamin B1, adenosine cobalamin and facial muscle rehabilitation exercises; the ultrasound permeation drug group was changed from oral prednisone to ultrasound permeation dexamethasone treatment with the application of ultrasound conductivity instrument in the facial nerve body surface permeation area to relieve facial nerve edema on the basis of conventional treatment. The acute phase recovery of facial nerve function, pain relief, time required for healing, and adverse effects were observed in both groups for comparison. The results showed that 18 cases (45%) improved and 22 cases (55%) were ineffective in the conventional treatment group at 7 days of treatment. In the ultrasonic drug penetration group, 9 cases (22.5%) were cured, 19 cases (47.5%) were effective, and 12 cases (30%) were improved. At 14 days of treatment, 1 case (2.5%) was cured, 7 cases (17.5%) were effective, 28 cases (70%) were improved, and 4 cases (10%) were ineffective in the conventional treatment group. In contrast, 31 cases (77.5%) were cured and 9 cases (22.5%) were effective in the ultrasound drug penetration group. In the evaluation of neurological function on 7 and 14 days of treatment, the ultrasound drug infiltration group had better results than the conventional treatment group, and the difference was significant. In terms of pain scores at 7 and 14 days of treatment, both groups were able to reduce pain, but the ultrasound drug infiltration treatment provided better relief than conventional treatment. The mean number of days to effect in the conventional treatment group was (19.43±4.24) days and in the ultrasound-permeable drug group was (8.65±2.93) days. No adverse effects were observed in the ultrasound-permeable drug group. Conclusion: Ultrasound infiltrated glucocorticoids have more direct anti-inflammatory and reduce facial nerve edema effects, which can relieve the condition of patients with Bell’s palsy in the acute phase more quickly. It can promote the restoration of facial nerve function and relieve pain.