A full-term male newborn presented to us at the age of 2 weeks with left facial weakness that had started at the age of 4 days and steadily progressed over a 10-day period. Physical examination revealed a complete unilateral left peripheral facial nerve paralysis, with an erythematous dull and bulging left tympanic membrane. Computed tomography and magnetic resonance imaging were normal. The patient underwent left myringotomy and placement of a pneumatic equalization tube within 24 hours of presentation. He also received a 5-day course of prednisone and a 2-week course of antibiotics and acyclovir. Improvement of the facial paralysis was rapid, with near-complete resolution at the time of discharge home and complete resolution 6 weeks later. To our knowledge, this is the only reported case of acute otitis media with associated facial nerve palsy in a newborn during the first 2 weeks of life.