A 16 year old amateur soccer player sustained a minor head injury while contesting a ball in the air. He was unconscious for two minutes and remained "dizzy" for about an hour. After two days he developed a profound left lower motor neurone facial nerve palsy. He was found to have a complex fracture of the left petrous temporal bone, with fluid in the left middle ear and left mastoid. Treatment was conservative with oral steroids and oral co-amoxiclav and a left myringotomy to decompress his middle ear. The spectrum of aetiology, presentation, and prognosis for facial nerve injuries is discussed.