In patients with spinal cord injury secondary to neurogenic detrusor overactivity, the standard treatment regimen is clean intermittent catheterization combined with anticholinergic medication. However, in our clinical work, we often encounter patients who do not respond well to conventional anticholinergic doses and who are prone to urinary incontinence, urinary tract infection, and/or upper urinary tract dysfunction. To evaluate the efficacy and safety of this treatment using botulinum toxin type A (BOTOX) injections into the bladder wall in patients with spinal cord injury secondary to neurogenic detrusor overactivity, the investigators included subjects from patients with spinal cord injury who had neurogenic detrusor overactivity confirmed by cystometry, and all had urinary incontinence (at least once a week), anti-cholinergic drug efficacy poorly, or discontinued treatment due to adverse drug reactions. After a 2-week washout period of anticholinergics, these patients received 200 units of BOTOX bladder wall injections, and they underwent urodynamic testing before and 1 month after treatment. In addition, they also underwent assessment of data related to indwelling catheterization and urinary incontinence, the International Incontinence Consultation Questionnaire assessment, which was performed both before and after treatment, and the post-treatment assessment was monthly until the termination of the effect of treatment. A total of 19 subjects, 13 males and 6 females, aged 22 to 67 years, were included in the study. One month after the injection treatment, the number of incontinence episodes decreased from 4.3 per day before treatment to 1.5 per day after treatment, while bladder volume increased from 100 ml before treatment to 296 ml, a statistically significant difference. The percentage of patients with effective treatment (reduction in the incidence of daily incontinence to less than 50%) was 74%. The effectiveness of treatment lasted from 3 to 12 months in the absence of anticholinergic treatment. No significant adverse events were observed by the investigators. The results of this study indicate that bOTOX treatment is effective and safe in patients with spinal cord injury secondary to neurogenic overactivity of the forced urinary muscles.