Background Very few studies are available in the management of facial nerve paralysis with alternative therapies. Methods A medical case is reported with facial nerve paralysis grade V (FNPV) managed with combined medical and alternative therapy, a relatively new modality in management options.Results A 23-years old Saudi woman presented with FNPV according to the House-Brackmann grading system. The patient was immediately offered management with combined drug therapy and alternative therapy for 3 months. ConclusionIn spite of the current debate regarding the application of alternative therapies in treating patients with medical conditions, this 23-year old woman with FNPV recovered significantly after 3 months' treatment using a combination of medical and alternative therapies. We conclude that offering alternative therapy, specifically wet cupping, or Hijama, in treating difficult medical conditions like FNPV can aid in the complete recovery of the condition.