Intra-aural tick, also known as otoacariasis is commonly seen in Otorhinolaryngology (ORL) clinics, both in paediatric and adult patients. Patients mainly complain of otalgia or ear discomfort. Facial nerve paresis complicating of intra-aural tick is a rare condition. We report a three-year-old girl, who presented with left unilateral facial nerve palsy and middle ear effusion three days after removal of intra-aural tick.