The use of Botulinum toxin (BoNT) in the field of urology has brought significant advancements in the treatment of various urological conditions. This study aims to review the different applications of BoNT in urology, evaluate its effectiveness, and explore its potential future implications. BoNT has been widely used in the field of urology for various conditions. In urology, BoNT has been primarily used for the treatment of detrusor overactivity, both neurogenic and idiopathic, as well as overactive bladder and bladder pain syndrome. It has also shown potential in the treatment of detrusor sphincter dyssynergia and dysfunctional voiding. However, the evidence for its use in benign prostatic hyperplasia is conflicting, and it is not recommended for regular clinical use. BoNT has also been explored for its use in other urological disorders such as interstitial cystitis/bladder pain syndrome and chronic pelvic pain. Overall, BoNT has revolutionized the treatment of lower urinary tract conditions refractory to conventional therapy and continues to be an area of active research and development in urology.