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Objectives : To comprehensively map and synthesize the clinical research trends, application patterns, and safety profile of botulinum neurotoxin (BoNT) injections administered based on acupoints or acupoint-based concepts.Methods : We conducted a scoping review following the PRISMA-ScR guidelines.A systematic search was performed in PubMed and CNKI from database inception to February 1, 2026, using combinations of terms related to "botulinum toxin" and "acupoints/acupoint injection."Eligible studies were primary clinical studies in humans in which BoNT was explicitly administered according to acupoint or acupoint-based injection concepts, with sufficient information on toxin type, dose, and injection sites.Results : Eighty-three records were identified, of which 11 studies met inclusion criteria.Two were randomized controlled trials, with the remainder being prospective single-arm studies, non-randomized comparative studies, case series, or case reports.Indications included migraine or vestibular migraine (n=5), musculoskeletal pain (n=2), spasticity (n=1), and blepharospasm/hemifacial spasm (n=2), plus one status migrainosus case.Frequently used acupoints included EX-HN3, EX-HN5, GV20, GB8, GB20, and BL10; musculoskeletal studies also used Ashi (tender) points.Reported outcomes generally favored acupoint-based BoNT in reducing pain, attack frequency, or spasticity.Adverse events were reported in 7 studies and were mostly mild and transient.Conclusions : Acupoint-based BoNT-A injections have demonstrated efficacy and safety across various clinical indications, suggesting their potential value in clinical practice; however, further scientific research and clinical evidence are warranted.