Facial palsy can occur as a result of various pathological processes, which are not always amenable to early diagnosis. This article is a case presentation of a patient with facial palsy, after an acute otitis media manifestation, as a first symptom of Wegener's granulomatosis. The clues leading to diagnosis consist of the practitioner's clinical suspicion of the disease, the use of the appropriate serological measurements (c-antineutrophil cytoplasmic autoantibody), and the histological confirmation. The early initiation of treatment leads to high rates of remission of an otherwise lethal disease.