Craniocervical dystonias are a major therapeutic problem, since in the majority of cases various drug regimens as well as surgical interventions either fail or are accompanied by serious side effects. Botulinum toxin, well known as a biological toxin which blocks the cholinergic neuromuscular synapse, proved to be a new and successful concept in the treatment of these disorders. In the present study, mechanisms of action, clinical indications and practical use of botulinum toxin are described.