Some facial palsy patients develop bilateral and/or recurrent facial palsy. To clarify the characteristic of bilateral and recurrent facial palsy, we retrospectively investigated 193 patients with bilateral and recurrent facial palsy in the 3385 patients who were treated for facial palsy during the past 3 decades. Among the 193 cases, 62 patients had ipsilateral recurrent palsy, 25 patients had bilateral simultaneous palsy, 88 patients had bilateral alternative palsy, and 18 patients had bilateral recurrent palsy. The major cause of palsy was Bell's palsy, and it accounted for 84.5% (163/193). Traumatic palsy, Guillain-Barré syndrome and facial schwannoma were rare, with rates below 3%. Therefore, the 163 patients with Bell's palsy were further investigated, and the following characteristic were found. (1) Patients with bilateral alternative palsy were more frequently associated with diabetes mellitus and hypertension, and patients with bilateral recurrent palsy were more frequently associated with diabetes mellitus than patients who had a single ipsilateral palsy. (2) The age at the first episode in patients with bilateral recurrent palsy and ipsilateral recurrent palsy was significantly younger than that in those without recurrent palsy.