Spasticity is one of the most devastating musculoskeletal sequelae of brain injury because it leads to functional impairments that augment disability. In spite of recent therapeutic advances, spasticity remains one of the most challenging impairments encountered by physiatrists. When treating brain-injured patients, drug side effects become a crucial consideration in determining appro-priate treatment because many of the individuals cannot afford the known sedative and adverse cognitive effects of many spasmolytic medications. For this and several other reasons, spasticity management in brain injury is complex and requires certain considerations to increase the likelihood of therapeutic success.