Botulinum toxin is a safe and effective treatment option for axillary hyperhidrosis. Although its pathophysiology is not clear and somewhat controversial, the beneficial effect of neuromodulators in inhibiting localized sweating temporarily is well known. Before the procedure, correct identification of the affected area is mandatory to avoid wastage of drug and neglect of target areas, and to enhance efficacy, as the hyperhidrotic location may not match the hairy axillary region. Utilization of this medication, such as dilution and injection techniques, depends on medical experience and may have some variations, including methods to make the procedure as painless as possible.