An overview is given of the indications, results and complications with the use of botulinum A toxin injection therapy specifically in the treatment of facial dystonias. A total of 79 patients have been treated over a 5-year period. The patients were divided in four groups: essential blepharospasm, hemifacial spasm, apraxia of the opening of the eyes and spastic entropion. On average, the therapeutical effect started the third day after injection. The average duration of the beneficial effect was dependent of the underlying pathology. Local side effects were mild and systemic side effects were not seen. Botulinum A toxin therapy proved to have a reliable and reproducible effect in appropriate dosages, in 90% of the patients.