Facial nerve paralysis has a great effect on patient’s quality of life. Treatment is very complex and not always with satisfactory results. Facial nerve paralysis can have many different etiologies. It can be caused by trauma, infection, neurological diseases, toxins, or it can be iatrogenic or congenital. History and clinical examination are very important for treatment. Through decades many different surgical treatments have been described. They can be divided in static and dynamic procedures. Selection of treatment depends on the time of paralysis, patient’s general health, age, and motivation for rehabilitation, type of injury, etiology of the paralysis, location of injury, and oncologic status. Static procedures can be done alone or in combination with dynamic procedures. They include temporary or permanent tarsorrhaphy, insertion of gold weights, palpebral springs or lid magnets, brow lift or suspension, forehead skin excision, unilateral facelift type procedures, static slings, nasolabial fold modification, and external nasal valve repair. Dynamic procedures include nerve repair, facial nerve decompression, harvesting nerve grafts (greater auricular nerve, sural nerve), primary nerve grafting, cross-facial nerve grafting (one or 2 stage), nerve transfer (hypoglossal nerve, nerve to masseter, glossopharyngeal nerve, accessory nerve, phrenic nerve), local muscle flaps (masseter, temporalis myoplasty), cross-facial nerve grafting with free muscle transfer in 1 or 2 stage procedures (gracilis muscle, pectoralis minor, latismus dorsi, rectus femoris, extensor digitorum brevis, serratus anterior, rectus abdominis, platysma).