Objective:To assess the feasibility of temporal bone magnetic resonance imaging for evaluating the severity and prognosis of idiopathic acute facial nerve palsy.Methods:Forty-four patients with idiopathic acute facial nerve palsy who had undergone gadolinium-enhanced magnetic resonance imaging were selected retrospectively. The degree of radiological facial nerve enhancement was determined using quantitative analysis (with region-of-interest measurements for separate facial nerve segments) and using subjective visual analysis. The clinical severity of facial nerve palsy was then correlated with the degree of facial nerve enhancement.Results:The visually determined degree of facial nerve enhancement did not correlate significantly with the House–Brackmann grade at either the early or late stages (p > 0.05). Results using the region-of-interest system were similar (p > 0.05).Conclusion:Temporal bone magnetic resonance imaging is not essential for patients with acute facial nerve palsy.