Objective·To explore factors influencing the efficacy of facial nerve decompression. Methods·Thirty-two patients with peripheral facial palsy who underwent facial nerve decompression in the Department of ENT Head and Neck Surgery at Shanghai Sixth Peoples Hospital affiliated to Shanghai Jiao Tong University between 2013 and 2015 were included in this study. The House-Brackmann facial nerve grade was used as the evaluation standard to analyzed factors such as course of disease, age, sex, cause of disease, and results of pre-operative facial nerve ENoG test. Results·Univariate and multivariate analysis revealed that the efficacy of decompression performed within 8 weeks of the onset of facial palsy was much better than that after 8 weeks and the difference was statistically significant. Other factors did not influence the efficacy of facial nerve decompression. Conclusion·The timing of surgery is a factor influencing the efficacy of facial nerve decompression surgery.