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Objective :To study the efficacy of BTX-A in the treatment of masseteric muscle hypertrophy.Methods :8 patients (16 sides) were treated by intramuscular injection of BTX-A, according to the thickness of the masseter muscle, each masseter was injected in 40-60U BTX-A respectively, the injection was divided into 3-5 points to be completed.The uhrasonogram was used to measure the thickness of the masseter muscle before and 1, 2 and 4 months after BTX-A injection.The change of the thickness of the injected muscle was recorded.Results :We observed that the masseter began to become obviously atrophy 1 month after BTX-A injection.The thickness of injected muscles which measured by the ultrasonogram was decreased from(1.2±0.15)cm to(0.67±0.13)cm 2 months after injection, the average reduction of the injected muscle is 31.3% compare to the volume before injection.The obvious muscle atrophy lasted for around 4 months for most of the patients,and then, it would have a slowly recovery but make a secondary injection in the porper time could prolong the therapeutic effects.Conclusion :BTX-A injection is a safe and effective treatment for masseteric muscle hypertrophy, which can replace the masseter resection.