Thirty-nine patients with blepharospasm were treated with botulinum A toxin. Twenty-six patients had essential blepharospasm, and thirteen had a hemifacial spasm. A total of 113 injections were given, and the average follow-up was 14.6 months. The mean preinjection spasm intensity was 2.9+ and the mean postinjection spasm intensity was 0.7+. The mean interval between injections was 4.4 months. The treatment was effective, although transient, in all patients with essential blepharospasm and hemifacial spasm. The toxin had a prolonged effect on the patients who had previously undergone muscle stripping procedure. The side effects were mild, transient, and local.