It is difficult for surgeons to repair and reconstruct abdominal wall defects, especially the complex abdominal wall defects. Various abdominal wall surgical techniques and mesh materials have brought more options for the treatment of abdominal wall defects. However, the treatment of complex and large abdominal wall defects with abdominal wall dysfunction remains a challenge. Botulinum toxin type A (BTA) injection into the lateral abdominal wall muscles has become one of the hot spots in the treatment field of abdominal wall defects because it can paralyze the abdominal wall muscles and narrow the abdominal wall defects. Based on the clinical experience, this article reviews the application of BTA in the treatment of complex abdominal wall defects.