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<h3>Background and Importance</h3> Post-mastectomy Pain Syndrome (PMPS) is characterised by chronic neuropathic and musculoskeletal pain following breast surgery. In the early stages, pain can be temporarily managed with analgesics. Botulinum neurotoxin type A (BoNT-A), by inhibiting the release of acetylcholine and reducing muscle contraction, offers a longer-lasting effect. <h3>Aim and Objectives</h3> To evaluate the effectiveness of BoNT-A in pain control in patients with PMPS. Analyse the variability between different BoNT-A presentations. <h3>Material and Methods</h3> Retrospective observational study in a secondary-level hospital between February/2019-August/2025, including patients treated with BoNT-A for pain relief by PMPS. Data were obtained from the FarmaTools Outpatient Dispensing module and the Mambrino XXI electronic medical record. Demographic variables, toxin presentation and dose, dose variations, number of infiltrations, frequency of administration, previous analgesics and clinical improvement were recorded. Data were analysed statistically using the SPSS program. Categorical variables (including dichotomous variables) were expressed as frequency and percentage, and continuous quantitative variables were expressed as median and interquartile range. Spearman’s correlation was used to assess associations between age, prior analgesic use, and frequency injection. <h3>Results</h3> We included 32 patients, all women, with a median age of 50±10 years. The majority received Xeomin (62.5%, 127.5±50Ul), Botox (25%, 116±50Ul); Dysport (12.5%, 500Ul). Regarding dose evolution, 59.4% maintained the same dose throughout treatment, while 18.6% needed higher doses and 21.9% needed lower doses during treatment. The median infiltrations were 2 (IQR 1.75) and median administration interval was 5 months (IQR 7.75), with a maximum of 36 months, with a maximum interval between sessions of 36 months. Regarding clinical evolution, 57.3% reported excellent improvement after 1°infiltración, 30.2% acceptable and 12.5% without improvement, trends maintained in successive infiltrations (42.9% excellent). Spearman showed no significance between age and clinical effectiveness. In contrast, there was a negative correlation between the frequency of administration and previous analgesics (rho=-0.894; p<0.05), with a lower number of previous analgesics being associated with a higher frequency of infiltrations. Finally, Kruskal-Wallis showed no statistically significant differences between clinical improvement and BoNT-A presentation (p=0.523). <h3>Conclusion and Relevance</h3> BoNT-A showed high efficacy in pain control in PMPS, with significant improvement after the first and successive infiltrations, consistent with other related studies. <h3>Conflict of Interest</h3> No conflict of interest