A 75-year-old male presented with left facial nerve palsy 19 days after initiating CAR-T therapy for multiple myeloma. He developed fever, chills, and rigors 8 days post-CAR-T, which resolved with Tylenol (tocilizumab not administered). Contrasted brain MRI did not show abnormalities and his facial palsy was treated with prednisone 60 mg and Valtrex 1000 mg every 8 hours for 7 days. Left facial palsy persisted despite treatment and progressed to involve bilateral facial nerves and left cranial nerve VI by 31 days post-CAR-T. Specifically, his exam showed impaired abduction of left eye and twitches of orbicularis oculi without other facial movement (House-Brackmann grade VI bilaterally). Another contrasted MRI brain showed mild enhancement of bilateral facial nerves. Extensive serum and CSF testing was unremarkable. Initial treatment with prednisone 60 mg PO was ineffective. This was escalated to methylprednisolone 1 gram IV daily for 1 day, followed by 500 mg IV for 2 days, then a prolonged oral prednisone taper (39 days of therapy total). Concern for the impact of high dose steroids on CAR-T efficacy influenced treatment dose and duration. Anakinra was considered but not given. He had resolution of CN VI palsy at 2.5 months from onset (2 weeks after completed therapy), and moderate improvement of bilateral facial palsy 5.5 months from onset (3.5 months after completed therapy).