Background Traumatic injuries to the facial nerve during its intratemporal course are uncommon and their management controversial. Facial nerve injuries occur in 7% of temporal bone fractures, especially transverse fractures. Complete facial nerve paralysis secondary to avulsion within its intratemporal course has only been reported once before. Method We describe the second case in the literature of intratemporal facial nerve trunk avulsion injury and discuss lessons learned. Case A 54-year-old female presented with a large wound around her left ear and a complete left-sided HB-VI facial nerve palsy after a dog attack. CT demonstrated a large tooth-shaped defect in the mastoid bone and suspected disruption to the vertical segment of the facial canal. The distal end of the facial nerve trunk was identified during surgical exploration, having been transected proximal to the pes anserinus and avulsed out of the stylomastoid foramen. The vertical segment of the facial canal was explored to the second genu, with no evidence of the proximal nerve segment. The decision was made not to further explore through a posterior craniotomy a posterior fossa craniotomy due to the invasive nature of the approach and the risk of synkinesis. Instead, our patient had a staged reanimation procedure, with cross-facial nerve grafts and end-to-side coaptation of the distal end of her left facial nerve stump to her left hypoglossal nerve, with a good outcome. Discussion: The evidence on management of traumatic intratemporal facial nerve injury is conflicting and inconclusive, with very only one reported case of complete intratemporal facial nerve discontinuity. In that case, described by Corrales et al, the distal segment of the facial nerve was rerouted and primary neurorrhaphy was performed. In our case, primary neurorrhaphy was not possible and we performed reanimation surgery. This has been shown to have equivalent outcomes for facial function and produced a good outcome for this patient.