A 20-year-old woman reported about giggle incontinence despite antimuscarinic therapy. Therefore we injected botulinum toxin A into the detrusor muscle. The effect of botulinum toxin A appeared about 1 week after injection and no more leakage was observed even during vigorous laughter. A control uroflowmetry showed a good voiding rate without any residual volume. Botulinum toxin A might be an alternative for patients with giggle incontinence after unsuccessful antimuscarinic treatment.