Recently, botulinum neurotoxin type A (BoNT-A) application in the lower urinary tract has been extended to prostate disorders and we would like to review the literature on the mechanisms of action and clinical efficacy of BoNT-A treatment in the prostate. The information was gathered from MEDLINE, abstracts from recent urological meetings and from personal experience. BoNT has demonstrated promising preliminary results for male prostatic disease and translational research suggests a novel mechanism of action of BoNT in the prostate. It is important to remember that the application of BoNT in the prostate is not approved by the regulatory agencies and caution should be applied until larger randomised clinical studies are completed.