Botulinum toxin is now widely used in neurology for the treatment of disorders involving muscle hyperactivity. Focal dystonia is the primary indication, and the key to effective treatment of dystonia is tailoring the treatment to the individual’s pattern of muscle involvement; even complex and generalized dystonias are treated as a collection of focal disorders. The dystonias known to respond to botulinum-toxin therapy include cervical dystonia, blepharospasm, laryngeal dystonia, writer’s cramp and anismus. Spasticity is another, growing, indication for the toxins. The treatment of these disorders with botulinum toxins is reviewed here.