Ramsay Hunt syndrome (herpes zoster oticus) is characterized by vesicles on the pinna, otalgia, facial nerve palsy and hearing loss. The most common clinical appearance was vesicular eruptions and facial nerve palsy including change in nasolabial fold and location of the lip. Although early systemic steroid is administered, facial nerve palsy persists in more than 50% of the patients. High intensity focused ultrasound (HIFU) has become one of the most popular non-invasive technologies for skin tightening and face lifting. HIFU is a highly precise medical procedure that delivers high-intensity focused ultrasound to the deeper layers of the skin. A 42-year-old man who had been diagnosed as Ramsay Hunt syndrome 4 years ago presented with facial asymmetry due to left facial palsy. Left eyebrow, left eyelid and left angle of mouth were sagging down. 2 months after a single session of HIFU treatment, left eyebrow and left angle of mouth were lifting. The patient was satisfied with improvement of facial asymmetry. We report the application of HIFU as a treatment tool to the face in a patient with facial asymmetry due to left facial palsy by Ramsay Hunt syndrome.