It was in 2002 when two of us, Steffen Berweck and Florian Heinen, first began to use sonographic imaging for improved accuracy of botulinum toxin injections (1,2). During recent years we saw a rapidly increasing acceptance of this technique. It was obvious that more and more users realized the importance of accurate toxin injection for achieving the best possible efficacy of this substance. Today, sonographically guided injection has become a standard procedure in pediatric practice and, generally, for injections into the forearm in upper limb spasticity. In this book we have tried to summarize the state of the art in the treatment of spasticity with botulinum toxin. Building up on our earlier book on this subject (3,4), we expanded the visual material which we believe allows faster orientation and a clearer approach. We hope that readers will find this book a source of helpful information for the effective and safe use of botulinum toxin in the treatment of spastic movement disorders. Urban Fietzek Steffen Berweck Jörg Wissel Florian Heinen