Objective. We assess relevant points to the botulinum toxin type A (BTX) injection and its effect on the lateral muscle complex (In-ternal oblique, External oblique, and Transversus Abdominus) as well as its safety in patients with ventral hernias (VH). Materials and methods. We used BTX in 5 patients who had a high risk of developing abdominal compartment syndrome after ventral hernia repair. The article describes the technique of BTX injection into the lateral muscle complex. Results. In one case, the injection of BTX did not lead to a sufficient effect, and anterior separation plasty was needed additional-ly. BTX was effective in preventing abdominal compartment syndrome in 80% of patients. There were no signs of intra-abdomi-nal hypertension in the postoperative period and after 12 months. No patients had relapses of VH. One patient had a hematoma; the other had a seroma that did not require significant interventions. In both cases, there was no connection with BTX injections. Conclusions. BTX injections seem to be a promising alternative to conventional methods to avoid intra-abdominal hypertension and abdominal compartment syndrome. © 2022, Media Sphera Publishing Group. All rights reserved.