This chapter provides updated information about the accuracy of and inherent advantages/disadvantages of guidance techniques available to clinicians during chemodenervation procedures. Experienced injectors use a variety of guidance techniques when performing botulinum neurotoxin chemodenervation procedures. The chapter addresses questions that many clinicians ask including, “Why should I learn a new technique?” and “Does ultrasound (US) provide added benefit?” The accuracy of US guidance for a variety of procedures including neurologic and musculoskeletal applications is well established. It is clear that US provides clinicians additional information than when using electromyography (EMG) or electrical stimulation (E-Stim) alone. With the increased portability and decreased cost of US equipment, this technology has become accessible to physicians of various specialties. These clinicians are likely to recognize the benefits of US and add US as a stand-alone technique or in combination with EMG and E-Stim to increase the precision and accuracy of chemodenervation procedures.