In order to study the condition of facial nerve bone canal in patients with nerve palsy and the therapeutic effect of acupuncture Hegu point therapy on patients with facial palsy, in this study, 70 patients with bell facial paralysis who were admitted to Beijing Friendship Hospital on July 30, 2018 solstice and July 30, 2019 were selected. The patients were randomly divided into a control group (CG) (n = 35) and an experimental group (EG) (n = 35). The EG received acupuncture and acupoint Hegu treatment, while the CG received conventional drug treatment. Magnetic Resonance Computerized Tomography (MRCT) image combined with multiplanar reconstruction (MPR) facial nerve tube measurement technique was used to detect genu ganglion segment, nerve labyrinth segment and tympanic compartment of bell facial paralysis patients in the EG. Patients in both groups were evaluated by House-Brackmann scale, Sunnybrook Facial Grading System (SFGS) scale, and Degree of facial Nerve Paralysis (DFNP). Finally, Logistic Regression Model (LRM) was used to analyze the factors influencing the treatment effect of bell facial paralysis patients. The results showed that the inner diameter of genu ganglion segment, labyrinth segment and tympanum segment of the EG was greatly smaller than that of the normal side, and the difference between the data was statistically significant (SS) (P < 0.05). After treatment, the House-Brackmann, SFGS and DFNP scores of patients in the two groups were greatly higher than before treatment, and the differences were SS (P < 0.05). After treatment, the scores of House-Brackmann, SFGS, and DFNP in the EG were greatly higher than those in the CG, and the differences were SS (P < 0.05). The analysis results of LRM indicated that DFNP score was negatively related to age and disease course (P < 0.05), and positively related to the neural labyrinth segment of the patients side (P < 0.05). MPR facial canal measurement technique based on MRCT can directly reflect the facial canal paralysis in patients with facial paralysis. Acupuncture at Hegu point can effectively improve facial nerve palsy and other symptoms in patients with facial paralysis of bell in clinic and the recovery effect may also be affected by the age of the patient and the course of the disease.