Background: Despite Bell's palsy is not a life threatening condition, it has a lot of psychological impact, up to now the exact underlying pathophysiology of bell's palsy is not fully understood, so we are trying to recognize the factors that affect its recovery. Methods: This prospective cohort study was executed on 60 patients with Bell's palsy who underwent complete blood count including calculation of neutrophil lymphocyte ratio, evaluation of severity using B-H scale and neurophysiological testing of the facial nerve with evaluation of motor amplitude and degeneration index of the nerve, then follow up was done after three months. Results: 18.3% of our patients had severe bell's palsy, the mean NLR in mild cases was 3.1 ± 0.17 versus 3.71 ± 0.36 for severe cases, high NLR and comorbid diabetes were found to be associated with increased severity of bell's palsy, old age and high NLR were associated with poor recovery after three months. Conclusion: Neutrophil lymphocyte ratio, old age, initial B-H scale, degeneration index and diabetes were found to possess a potent statistical value in predicting short term outcome of bell's palsy.