Background: Bell’s palsy occurs more frequently in the third trimester and has a well-documented association with hypertensive disorders of pregnancy. Its management poses unique challenges, including the need to balance maternal and fetal risks while reliably excluding central nervous system pathology, particularly stroke. Case Presentation: A 35-year-old multigravida with chronic hypertension and type 2 diabetes presented at 35+2 weeks with acute left-sided facial weakness, drooling, and retroauricular pain. Blood pressure was 150/96 mmHg without severe features of preeclampsia. Neurological examination revealed isolated left lower motor neuron facial palsy Laboratory evaluation showed mild anemia (Hb 8.7 g/dL), thrombocytopenia (platelets 110 × 10?/L), and proteinuria (1+ on dipstick). The sFlt-1/PlGF ratio was 19.89 (below the threshold for high-risk preeclampsia). She was diagnosed with chronic hypertension with superimposed non-severe preeclampsia and concurrent Bell’s palsy. Oral prednisolone 60 mg daily was initiated for 7 days, followed by a one-week taper. Facial weakness markedly improved within 48 hours and resolved completely by day 5. Fetal surveillance remained reassuring. Pregnancy was successfully prolonged to 37+3 weeks, when an elective repeat cesarean section was performed, yielding a healthy neonate. The mother had complete neurological recovery; postpartum hypertension was well-controlled on amlodipine 10 mg daily. Conclusion: Early corticosteroid therapy for Bell’s palsy in late pregnancy can achieve rapid and complete recovery. A non-high-risk sFlt-1/PlGF ratio (<38), in the absence of other severe features, supports safe expectant management and pregnancy prolongation when maternal and fetal status remain reassuring.