Intravesical injection of botulinum toxin-A (BTX-A) is a safe and effective treatment for patients with refractory overactive bladder (OAB). It works by interfering with nerve conduction calcium-dependent channels and blocking ionic channels to cause muscle relaxation and atrophy. This interference does not cause neurological degeneration. It also is reversible. Through literature analysis, the indications and contraindications of BTX-A injection, BTX-A dose, injection site, injection point, clinical efficacy, adverse reactions and other aspects are summarized and discussed. We wish to provide more detailed reference and guidance for BTX-A treatment of refractory OAB.