Cranial nerve (CN) VII palsy is a rare complication of neuraxial blockade. The likely etiology of the palsy is intracranial hypotension from cerebrospinal fluid loss leading to traction on CN VII. The presentation of symptoms of CN VII palsy from intracranial hypotension closely resembles a more common cause of CN VII injury, Bell’s palsy, and the 2 can be difficult to differentiate. We present a patient who had a dural puncture with development of a headache and CN VII palsy, which improved with epidural blood patch (EBP). EBP should be considered for patients with suspected CN palsy from intracranial hypotension.