Botulinum toxin is a corner stone in the facial esthetics. It has been used for decades for various medical and esthetic indications. Botulinum toxin is a neuro- toxin that interferes with the transmission at the neuromuscular/neurosecretory junctions by inhibiting the release of acetylcholine. An in-depth knowledge of the functional anatomy of facial muscles is required to obtain the best results of the botulinum toxin injections. In this book chapter, a detailed practical guide for the FDA approved and the off-label uses of botulinum toxin in the face is presented. The recently developed new indications are listed. The lengthy experience with botulinum toxin injections has proved safety and tolerability of the procedure; how- ever, the probable complications, and steps for their prevention and management are highlighted.