not-yet-known not-yet-known not-yet-known unknown Objective: Investigate the impact of high glycated hemoglobin A1c (HbA1c) on Bell’s palsy(BP) prognosis, adjusting for confounders like age and Body Mass Index(BMI). Design: A retrospective propensity score-matched study. Setting: University-affiliated teaching hospital. Participants: 3251 patients diagnosed with BP and admitted to Hospital of from May 4, 2018, to May 9, 2023, were included. After propensity score matching (PSM),patients were categorized into 103 individuals with HbA1c≥6.5% and 103 individuals with HbA1c<6.5%. Outcomes: Evaluated demographical, clinical characteristics and facial dysfunction severity before and after PSM. Results: High HbA1c patients were older (P<0.001), had higher BMI (P<0.001), and less frequently suffered dysgeusia (P<0.001) and more often had hypertension (P<0.001). Age had the greatest influence on HbA1c levels (95% CI=0.748-0.803, P<0.001). Post-matching, no significant differences in age or other factors (P>0.05). Initial House-Brackmann grade (H-B grade) showed no statistical difference (P=0.06), but final H-B grade did (P=0.002), indicating worse prognosis for high HbA1c patients. Conclusions: After controlling for age, BMI, dysgeusia, and hypertension, high HbA1c levels were associated with an unfavorable outcome for Bell’s palsy patients.