Botulinumtoxin A (BTX) is widely used for the treatment of spastic movement disorders in childhood. Safety and local efficacy of BTX are well documented by the experience of many users and verified by several clinical trials. Indications for the use of BTX in children include facilitation of care, better tolerance of ortheses as well as the quantitative and qualitative improvement of motor abilities. This article differentiates clinical indications for which the use of BTX has been proven from those in which effectiveness is only suspected or is yet unclear.