Botulinum toxin, originally identified in relation to botulism, has evolved from being considered a perilous pathogen to an invaluable therapeutic agent. First utilized by Alan Scott in 1977 to treat strabismus under the commercial name, Oculinum, the toxin received Food and Drug Administration approval in 1989 and was subsequently rebranded as Botox. Its clinical applications have expanded notably, especially in the field of otolaryngology, proving effective in managing conditions such as spasmodic dysphonia, essential vocal tremor, and chronic salivary gland disorders. Moreover, botulinum toxin has shown promising results in treating persistent chronic rhinitis, objective tinnitus, and synkinesis following facial palsy, significantly improving involuntary facial movements. This paper details the diverse applications and methodologies of botulinum toxin across various ENT disorders, illustrating its growing scope and significance in medical practice.