Objective To explore the effect of acupuncture combined with Qufeng Huoluo decoction on facial motor function and facial nerve function in patients with peripheral facial paralysis. Methods A total of 50 patients with peripheral facial paralysis admitted to Shanyang Traditional Chinese Medicine Hospital from January 2023 to January 2025 were selected as the research subjects, and they were divided into the control group (n =25) and the study group (n =25) by the random number table method. The control group was treated with Qufeng Huoluo decoction, and the observation group was treated with acupuncture+Qufeng Huoluo decoction. The facial motor function, facial nerve function and quality of life were compared between the two groups. Results After 4 weeks of treatment, the score of H-B facial nerve function grading scale in the two groups decreased, and that in the study group was lower than that in the control group (P <0.05). The facial nerve function index score in the two groups increased, and that in the study group was higher than that in the control group (P <0.05). The Facial Disability Index scores in the two groups improved, and the physical function score in the study group was higher than that in the control group, while the psychosocial function score was lower than that in the control group (P <0.05). Conclusion For patients with peripheral facial paralysis, acupuncture combined with Qufeng Huoluo decoction has an ideal value, which can improve patients' facial motor function, and optimize their facial nerve function and quality of life.