The authors evaluate the clinical outcome of botulinum toxin (BT) injection in the correction of esotropia in 44 patients with cerebral palsy (CP). BT was injected under general anaesthesia without EMG guidance. Of the children, 47.7% were male and mean age was 47.56 ±30.86 months (5-124 months). There was no significant difference in outcome at 12 months for those with greater or less than 50 dioptres of esotropia at time of injection. Complications included subconjunctival haemorrhage (n=6) and ptosis (n=17). Success rate at one year was 68.18%. Rates of overcorrection and under correction were 43% and 6.8% respectively at one month, and 6.8% and 25% at one year. Lower age, ptosis, larger pre-injection deviation and less esotropia one month post injection may be predictive factors for achieving better results. The authors conclude that BT is a reasonably less invasive and scar-free procedure for the early management of these children, allowing more surgical options for later management as required.