Botulinum toxin (BoNT) has traditionally been utilized to relieve tension in muscular and connective tissue diseases (CTD). However, its usage has rapidly expanded and now encompasses usage for neurological, gastrointestinal, psychological, cardiovascular, ophthalmology, orthopedics, and more. More recently, its usage has been utilized for sequelae of CTDs such as Raynaud's disease and reduced oral aperture secondary to scleroderma/systemic sclerosis. Beyond its current applications, BoNT holds promise in various medical fields but is not FDA-approved in these conditions. Thus, the design and conduction of well-designed randomized controlled trials are essential in establishing the efficacy and safety of BoNT treatment which can help accelerate regulatory approval for new indications. The versatility of BoNT suggests that its therapeutic applications continue to expand, offering novel therapies for a wide range of conditions. This review aims to comprehensively evaluate the literature on BoNT's current FDA-approved indications and potential non-FDA uses in other medical conditions. Additionally, this review offers potential insights and future possibilities for BoNT treatment.