Dysthyroid orbitopathy or Graves’ orbitopathy (GO) is an autoimmune disorder usually associated with Graves’ disease. It occurs due to orbital muscle and fat tissue enlargement because of edema and deferment of glycosaminoglycans and collagen. It is more common in women and incidence is 16 women and 3 men out of 100 000 people. Smoking is the risk factor associated with orbitopathy appearance and progression and it leads to decreased therapy success. 25-50% of people have clinical manifestations of GO. Eyelid retraction, proptosis and difficulties due to ocular exposition are most often present. In an active phase of the disease there can be present more serious manifestations such as periocular soft tissue redness and edema, restrictive myopathy and diplopia, sometimes even dysthyroid optic neuropathy. It occurs in 5-7% of cases and manifests with the visual acuity loss and color recognition disorder. EUGOGO is a multidisciplinary association of clinicians who developed criteria for evaluation of GO patients. Based on these criteria it is decided who and how will be treated considering disease activity and severity. There are various treatment options depending on the severity of the disease which can be mild, moderate to severe or sight threatening that requires immediate attention. Botulinum toxin is an exotoxin produced by a gram positive bacteria Clostridium botulinum. Technological composition of botulinum toxin type A is used for treating various medical conditions. Main indications in patients with GO are eyelid retraction and strabismus in the acute phase of the disease. Mechanism of action is induction of reversible chemodenervation with transient effect lasting usually a couple of weeks or months. Operation is indicated when the disease is stable for at least 6-12 months.