Introduction: Injuries to the tympanic membrane or middle ear from welding are uncommon but can cause significant morbidity. Reported complications include canal wall burns, tympanic membrane perforation, chronic otorrhea, hearing loss, vertigo and rarely facial nerve palsy. We present a case of a 17-year-old boy who developed profound hearing loss and a transient facial nerve palsy following a workplace welding accident. Case: A 17-year-old male presented with a profound deafness and facial weakness after molten metal entered his ear canal while welding beneath a vehicle. He had immediate otalgia and ipsilateral facial weakness following the injury. He was wearing eye protection but no ear protection. Examination revealed canal burns, a complete tympanic membrane perforation, and a House-Brackmann grade VI facial nerve palsy. CT imaging demonstrated a 5mm metallic foreign body in the middle ear, inferior to the ossicles. The fragment was removed by microsuction. Audiology confirmed a profound mixed hearing loss on the affected side. He was commenced on high-dose steroids, antibiotics and eye cares. A nerve conduction study showed complete axonal lesion of the facial nerve and plans for facial nerve reconstruction surgery was made. The patient achieved full facial nerve recovery within three months, and his most recent audiogram demonstrated near-normal hearing. Discussion: Welding-related middle ear injuries are rare but potentially serious. This case highlights the risk of severe otologic injury from molten metal. Fortunately, this patient obtained a good result with minimal long-term hearing loss and recovery of his facial nerve function. This highlights the importance of considering delayed surgical intervention to allow time to assess the degree of facial nerve recovery. The routine use of ear protection during welding should be strongly advocated to prevent such injuries.