New trends and advances in botulinum toxin neuroscience paved the way to the better understanding of the toxin from its behavior at the bench to the clinics. As details of mechanism of action are clarified, we are ready to dispose of product myths, such as diffusion being related to the product being used. Our directions, more precisely on the important subjects such as dose targeting, will translate the science to robust clinical information. Additionally, aspects such as antibody formation, leading to treatment nonresponse, are now understood after long-term treatment series in a variety of dystonic conditions. Avenues leading to combinations of these areas of knowledge will lead to improved botulinum neurotoxin (BoNT) treatment, and further explore the potential of this toxin treatment in association with other treatment modalities, particularly in spasticity and dystonia.