The existing literature on facial nerve IONM outcomes is inconsistent, with some studies showing a significant reduction in immediate and permanent nerve paralysis incidence and severity and others revealing no substantial differences compared to control/non-monitored groups. The impact on surgery duration is also a matter of debate. The scarcity of high-level scientific evidence and the heterogeneity of available studies limit the statistical strength to recommend routine monitoring in parotid surgery. However, medicolegal considerations tend to reinforce the current monitoring role as a standard of care.