Background : Botulinum neurotoxin (BoNT) is indicated for the treatment of cranial dystonia, including essential blepharospasm, hemifacial spasm, and lid opening apraxia. Lower eyelid spasmodic entropion affects rather old people and is responsible for ulcerative keratitis and pain, due to the friction of eyelashes on the conjunctiva and the cornea. The common treatment is surgical. The treatment with BoNT of spasmodic entropion can be very accurate in some cases, particularly in unilateral entropion, to avoid asymmetry of the eyelids, in patients who cannot stop anti coagulants, and in very old patients who cannot withstand surgery. Patients : We treated 21 patients, on average 86.2 years old (66 up to 102), 20 with unilateral spasmodic senile entropion and 1 with a bilateral entropion. Methods : The pre-orbicularis muscle is injected in 3 or 4 points under the margin eyelid, avoiding the inferior lacrymal point. The mean total dosage of BoNT is 20 units of Botox ® (13 patients) or 40 units of Dysport ® (8 patients). Results : Three days after injection, the entropion had resolved. The average delay for re-injection was three months. The treatment was ambulatory, quick and painless. Conclusion : Injection of BoNT is safe and effective for selected cases of spasmodic entropion.