〔Abstract〕 Objective To observe the therapeutic effect of acyclovir combined with methylprednisolone in children with idiopathic facial palsy. Methods A total of 56 children with idiopathic facial nerve palsy admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to December 2021 were selected and randomly divided into a control group and an observation group, with 28 cases in each group. The control group was treated with methylprednisolone, and the observation group was treated with acyclovir on the basis of the control group. House-Brackmann facial nerve function, Portmann simple score before and after treatment and treatment efficiency were compared between the two groups. Results After two weeks of treatment, the House-Brackmann facial nerve function grade of the observation group was better than that of the control group, and the difference was statistically significant (χ2 = 8.07, P < 0.05). After treatment, the Portmann scores of the two groups were higher than those before treatment, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant (P < 0.05). The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion Acyclovir combined with methylprednisolone in the acute phase of the treatment of children with idiopathic facial paralysis is more conducive to the improvement of the condition.