The Centers for Disease Control and Prevention (CDC) issued an advisory on the risks of counterfeit or mishandled Botox injections after reports of harmful reactions in multiple states. The CDC, FDA, and local health departments are investigating clusters of 22 women who experienced adverse effects, including blurred vision, drooping eyelids, and shortness of breath, after receiving Botox injections. The incidents are linked to unlicensed or untrained providers and injections in non-healthcare settings. Counterfeit Botox products may have lot number C3709C3 and display the active ingredient as “Botulinum Toxin Type A” instead of “OnabotulinumtoxinA”. Clinicians are urged to consider the possibility of adverse effects from botulinum toxin injections and contact health departments if suspected. Botox should be administered only by licensed providers using FDA-approved doses and in healthcare settings.