OnabotulinumtoxinA (BTX-A) is a treatment option for patients with neurogenic detrusor overactivity (NDO) or idiopathic overactive bladder (OAB) inadequately controlled with or intolerant to oral medications. The currently approved dosing is 100 U for OAB and 200 U for NDO which is commonly injected into the detrusor muscle via 20-30 trigone-sparing sites. Growing evidence suggests that the efficacy of BTX-A may be maintained with fewer injection sites, varying injection depth, and differing injection locations. This review focuses on the recent literature regarding various BTX-A injection techniques for the treatment of NDO and OAB.