Objective To observe the effects of botulinum toxin injection on shoulder pain following stroke under ultrasonog -raphy and the recovery of the affected limb .Methods Seventy-five patients with shoulder pain following stroke were randomly divided into 3 groups: the botulinum toxin injection +conventional rehabilitation group ( group A ) , the triamcinolone acetonide therapy +conventional rehabilitation group (group B), and the conventional therapy group (group C).Fugl-Meyer upper-limb function scores, VAS scores and range of shoulder motion before and after treatment were evaluated and compared between the groups .Results Before treatment, there were no significant differences in Fugl-Meyer scores, VAS scores and range of motion (ROM) of shoulder for the pa-tients of the 3 groups(P>0.05).Four weeks after treatment, Fugl-Meyer scores, VAS scores and shoulder ROM all improved, as com-pared with those before treatment, and statistical significance could be seen, when comparisons were made between them (P<0.05). Fugl-Meyer scores , VAS scores and shoulder ROM for the patients of group A and B improved more significantly after 4 weeks of treat-ment, as compared with those of group C, with statistical significance (P<0.05).More significant improvement of Fugl-Meyer scores, VAS scores and shoulder ROM could be noted in the patients of group A (49.3 ±7.4,2.3 ±1.1,103.7 ±11.2,91.5 ±7.4), when com-pared with those of group B (40.0 ±5.1,3.7 ±1.2,79.4 ±9.3,74.3 ±9.2)(P<0.05).Conclusion Botulinum toxin injection com-bined with conventional rehabilitation training in the treatment of should pain following stroke was of great significance to the recovery of upper limb function following stroke , and without any adverse reactions .For this reason , it was worth further clinical popularization .