Abstract: Objective To determine the value of blink reflex in early diagnosis and prognosis evaluation of Bell palsy. Methods Blink reflex and facial nerve conduction were examined in 58 patients with Bell palsy within one week after symptom onset. The patients without response of R1, R2 and R2’ waves were classified as complete efferent retardarce (Group A, 30 cases), and those with response of R1, R2 and R2’ waves were classified as incomplete efferent anomalies (Group B, 28 cases). The clinical outcomes after three months of systemic therapy were evaluated using the House-Blackmann (H-B) scale. Results Efferent anomalies of blink reflex occurred in all of the 58 patients. Abnormal results of facial nerve conduction appeared in 23 (39.7%) patients. The three months therapy was effective in 93% patients in Group B and 70% patients in Group A (P<0.05). Conclusion Blink reflex can play a significant role in early diagnosis and prognosis evaluation of Bell palsy.