The number of men seeking botulinum toxin type A (BTX-A) has increased over the last decade. In addressing the needs of male cosmetic patients, clinicians cannot simply look to consensus statements and clinical trials for treatment guidelines when in fact the vast majority of clinical studies to date have been performed on predominantly female patient populations. This article discusses the reasons behind the recent demographic shift in the botulinum toxin market as well as the differences in perception of beauty across both genders. The available literature is reviewed to extrapolate and apply relevant data in the context of treating male patients. We also offer clinical pearls from our experience in a dermatology practice setting where the male cosmetic patient is strongly represented. Although there is no consensus on exact dosing regimens, as a general rule men require higher doses of all currently available neurotoxins. Furthermore, when evaluating male patients, clinicians must be cognizant of the Western ideals of male beauty while also taking into account each patient’s specific muscle mass, muscle fiber pattern, and hair distribution pattern.