Objective To explore the diagnostic value of 3.0T magnetic resonance high-resolution T2-weighted imaging for facial neuritis. Methods This study enrolled 50 patients clinically diagnosed with facial neuritis who were admitted to our hospital from September to December 2023. All subjects underwent three-dimensional variable flip angle fast spin-echo T2-weighted imaging (T2WI) scans. Based on the original imaging data, both maximum intensity projection (MIP) reconstruction and curved planar reformation (CPR) reconstruction were performed. The imaging characteristics of facial neuritis and the involved nerve segments were systematically evaluated, with comparative analysis against blink reflex test results. Finally, quantitative comparisons were made between the affected and unaffected sides regarding facial nerve diameter differences and relative signal intensity differences. Results Among 50 patients with facial neuritis, 42 cases successfully completed scanning, 30 cases were able to observe facial neuritis on magnetic resonance imaging.16 cases (53%) were involved in the tympanic segment, 23 cases (77%) in the mastoid segment, 11 cases (37%) in the parotid segment. 10 cases (33%) were involved in both the tympanic and mastoid segments, 7 cases (23%) were involved in both the mastoid and parotid segments, 3 cases (10%) were involved in all three segments. The consistency evaluation of the diagnosis of facial neuritis by two radiologists was good, with Kappa values>0.75.The detection rate of mild facial neuritis was 64%, which was statistically different from the results of blink reflex examination (P<0.05). The detection rate of severe facial neuritis was 86%, which was not statistically different from the results of blink reflex examination (P>0.05).The diameter of the affected and healthy side nerves were (1.71±0.09 mm, 1.47±0.14 mm, P<0.05). The ratio of nerve signal intensity between the affected and healthy sides was (2.31 0.28, 1.88±0.23, P<0.05).The areas under the ROC curves for the diameter of facial nerve and the ratio of signal intensity were 0.909 (with an optimal cut-off value of 1.62mm, sensitivity of 83.33%, and specificity of 90.00%) and 0.876 (with an optimal cut-off value of 1.99, sensitivity of 76.67%, and specificity of 80.00%), respectively. The area under the ROC curve for the combined diagnosis of facial nerve diameter and signal intensity ratio was 0.959, with a sensitivity of 96.67% and a specificity of 83.33%. Conclusion MIP and CPR images based on high-resolution T2 weighted magnetic resonance imaging can clearly display the facial nerve and it can be effectively used for the diagnosis of severe facial neuritis. The diameter of facial nerve and the ratio of signal intensity can be used as important indicators for the diagnosis of facial neuritis