Facial synkinesis is the long-term sequela of facial nerve injury that can result in severe deficits in facial expression and function. It is characterized by abnormal involuntary facial movements that accompany voluntary facial expressions. The type and severity of symptoms differ from patient to patient, which makes evaluation and management complex. Given the chronicity of the disease, appropriate evaluation is paramount to effective management. This article will discuss how to effectively evaluate patients in the office and associated treatment.