- Objective: To determine whether an association exists between Bell's palsy during pregnancy and adverse perinatal outcomes. Methods: A retrospective study comparing all singleton pregnancies of patients with and without Bell's palsy was conducted. Multiple logistic regression model was performed to control for confounders. Results: Out of 242,216 deliveries, 0.017% (n = 42) were diagnosed with Bell's palsy during pregnancy. Risk factors for Bell's palsy were chronic hypertension (9.5% vs. 1.5%, P < .001) and maternal obesity (7.1% vs. 0.8%, P < .001). Patients with Bell's palsy during pregnancy had higher rates of severe preeclampsia (9.5% vs. 1.1%, P < .001) and Cesarean deliveries (31.0% vs. 13.3%, P = .001) compared to the comparison group. In contrast, no significant association was documented between Bell's palsy and adverse perinatal outcomes such as low Apgar scores (<7) at 5 minutes (4.8% vs. 3.1%; P = .524) and perinatal mortality (2.4% vs. 1.4%; P = .57). Using multivariable analysis, controlling for confounders such as maternal age, fertility treatments, and ethnicity, Bell's palsy during pregnancy was significantly associated with obesity (odds ratio [OR] = 9.08 95% confidence interval [CI] 2.8–29.46; P < .001), chronic hypertension (OR = 6.69 95% CI 2.38–18.76; P < .001), and severe preeclampsia (OR = 9.46 95% CI 3.37–26.53; P < .001). Conclusions: Chronic hypertension and obesity are independent risk factors for Bell's palsy. Bell's palsy during pregnancy is significantly associated with severe preeclampsia. Nevertheless, no significant association exists between Bell's palsy and adverse perinatal outcomes.