Today, botulinum toxin (Btx) belongs to the standard repertoire in the treatment of spasticity. It is usually used in combination with other measures, such as oral or intrathecal medicinal products or physiotherapy. Btx improves the ability to walk and stand of patients with spastic equinus deformity and hip and knee flexor spasticity. Btx treatment eases the care of patients with severe adductor spasticity and flexor spasticity of the extremities and hands and also the self-care and dressing of patients with arm spasticity. Through the local application of Btx, painful spasms have become treatable without having to also accept the generally negative effects of, for example, oral antispasticity drugs. For children with congenital or who acquired spasticity in early childhood, the long-term treatment with Btx can fundamentally contribute to the improvement of motor development.