Background: a visible scars, particularly those located on the head and neck, tended to have a negative impact on patients’ psychology. The aim of the present study was to compare between the effects of Botulinum toxin type A (BTA) and silicone gel patch in prevention of scar formation.Method: twelve patients suffering from fracture of mandibular condyle and/or angle were treated by reduction and fixation through retro mandibular incision. The patients were divided randomly and received either BTA or silicone gel patch immediately after wound closure. Assessment of the scar was made using Vancouver Scar Scale (VSS) and Observer/patient Scar Assessment Scale (OPSAS), and Visual Analogue Scale (VAS) after 1 and 6 month follow up.Result: nine patients completed the trial. There was statistically significant difference in improvement of the scar appearance that treated by either BTA or silicone gel sheet from 1 month to 6 months according to (OPSAS) and VSS but there was no statistically significant difference between the two groups at one month, and 6 months regarding the OPSAS, VSS and VAS. Conclusions: BTA and silicone gel sheet has the same effect on prevention of the scar.