Technical Abstract: Botulinum neurotoxins (BoNTs) are some of the most potent biological toxins to humans. They are synthesized by the gram-positive, spore-forming bacterium Clostridium botulinum. BoNT is secreted from the bacterium as a ~150 kDa polypeptide which is cleaved by bacterial or host proteases into a ~50 kDa light chain and a ~100 kDa heavy chain disulfide-linked protein. The light chain of the toxin contains the catalytic domain that blocks acetylcholine release from neurons and results in flaccid muscle paralysis. Four serotypes of this pathogen have thus far been associated with human foodborne contamination. Due to their potent toxicity, botulinum neurotoxins pose bioterrorism concerns and are listed as Select Agents. Ironically, BoNTs, also known as BOTOX®, are used quite liberally among the population for cosmetic reasons. Less well known are the many medical uses of BoNT, such as treatment for strabismus, cervical distonia, and an ever-increasing list of medical ailments. In this review, BoNTs will be explored from perspectives as human poisons or medicines. New technologies to identify and neutralize the effects of the toxin will also be presented and discussed.