Essential blepharospasm is defined as the involuntary spasmodic bilateral closing of the eyelids. The symptoms are typically triggered by stress, fatigue, intense light, or individual factors. The disease is usually slowly progressive. Essential blepharospasm is predominant in females and often appears in people older than 50 years old. At advanced stages patients develop functional blindness as well as social withdrawal. There are several treatment modalities: systemic and ocular medications, surgical procedures, and botulinum toxin (BTX). A great variety of drugs have been recommended for treating essential blepharospasm with poor results. Surgical procedures should be limited to the rare patients that do not respond to botulinum toxin treatment. BTX administration has been an effective treatment and should be considered the first choice for essential blepharospasm. The application technique, efficacy and possible complications are discussed in this paper.