Traumatic facial nerve injuries are rare and can be associated with significant facial cosmetic deformity and functional disability. Most traumatic facial nerve injuries are caused by blunt force trauma resulting in petrous temporal bone fractures that disrupt the facial nerve. Penetrating mechanisms directly involving the facial nerve in its intratemporal course are considerably rarer. This case report describes an unlikely case of a 33 year old male who sustains an immediate facial nerve palsy after being stabbed in the right ear with an ice pick. Computed Tomography (CT) scans demonstrate the course of the icepick transversing the mastoid and penetrating the mastoid segment of the facial nerve – an unlikely, occult injury given the thin calibre of the ice pick. This report details the treatment and workup of this penetrating facial injury in relation to the current evidence in the literature regarding the management of penetrating facial nerve injuries.