The authors report findings from a retrospective single-centre study which aimed to evaluate the efficacy and safety of long-term botulinum A toxin (BAT) treatment in patients with blepharospasm (BPS). Blepharospasm is described as one of the most frequent types of facial dystonia and is characterised by excessive blinking, photophobia and forceful involuntary eyelid closure. The study consisted of 130 consecutive patients with BPS who were treated with subcutaneous BAT. The selection of muscles and dose administered was based on an individual patient need basis. Analysis was made in relation to clinical and demographic characteristics, number of sessions, dose, duration, effectiveness of treatment and adverse events. The median length of follow-up was 14 (95% CI 13-15.6) years. Concerning the efficacy of treatment, 114 (87.7%) experienced satisfactory results with functional and aesthetic recovery. Adverse events developed at least once during the treatment period in 39% of patients, with transient ptosis and haematoma the most commonly reported. The authors use the results to conclude that BAT is a safe and effective long-term treatment for blepharospasm, with mild, transient and well-tolerated side-effects when they appear.