Objective To analyze the clinical effect of acupuncture on the healthy side in the treatment of acute peripheral facial paralysis. Methods A total of 64 patients with acute peripheral facial paralysis admitted to the Department of Acupuncture and Moxibustion of Tongling Hospital of Traditional Chinese Medicine from June 2022 to July 2023 were randomly divided into control group and observation group, with 32 patients in each group. The control group was treated with acupuncture on the affected side, and the observation group was treated with acupuncture on the healthy side and then on the affected side. The clinical efficacy, hemodynamic indexes of facial artery, House-Brackfman facial nerve function grading system (H-B) score and recurrence were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups (P >0.05). The cure rate of the observation group was higher than that of the control group (P <0.05). After 1 and 2 courses of treatment, PVS in the observation group was higher than that in the control group, and RI was lower than that in the control group (P <0.05). After 1 course of treatment, the H-B score of the observation group was lower than that of the control group (P <0.05). There was no significant difference in H-B score between the two groups after 2 courses of treatment (P >0.05). The recurrence rate of the observation group was lower than of the control group (P <0.05). Conclusion The effect of acupuncture on the healthy side in the treatment of acute peripheral facial paralysis is good. It can effectively accelerate the rehabilitation process of facial nerve function in patients with acute peripheral facial paralysis, improve their hemodynamic indexes, and help to reduce the recurrence rate. Compared with the simple acupuncture on the affected side, its effect is better.