The study was done on twenty adult patients suffering from Bruxism, divided to two groups equally, first group was injected with botulinum toxin A in masseter and temporalis muscles bilaterally. The second patients group which managed by wearing a hard maxillary occlusal splint.The patients were evaluated before starting by; electromyogram EMG, Visual analogue scale VAS, evaluation of muscle tenderness and teeth wear, and evaluated after one, three and six months of startingEMG recordings of the masseter and temporalis muscles obtained from group of patient which injected with botox after one and three months of injection, show significant decrease in muscles amplitude specially muscles with high amplitude, after six months EMG reading elevated to level of reading before injection, and in group of patient which wears occlusal splint show no significant change in muscles amplitude over months.VAS obtained from group of patient injected with botox after one, three and six months, show significant decrease, but in group wear occlusal splint show decreases but less than that of Botox group.Regarding tenderness of temporalis and masseter muscle in group of patients injected with botox , level of tenderness show significant decrease after one, three and six months after injection, in group of patients which wears occlusal splint, level of tenderness in masseter muscle show decrease after one month , and after three and six months show no difference from the first month. but in temporalis muscle level of tenderness decrease in one month ,and improved more over three and six months.Teeth wear show no change in both groups.From the results of this study , Bilateral injections of Botulinum toxin type A (Botox) in both masseter and temporalis muscles is a successful treatment in sleep and awake bruxism at least for six months without side effects. Wearing hard occlusal splint prevent Bruxism events and decrease its related signs and symptoms and related damage to masticatory system, whenever patient wear it; but when patient stop using it, bruxism return immediately, so it cannot be considered as a treatment but act as a protection from its related damage.Local injection of Botox in masseter and temporalis muscle considered an alternative method for reducing bruxism in special need patient who was not a good candidate for intraoral appliance.