Contact granuloma has been associated with voice abuse, laryngopharyngeal reflux, and habitual throat clearing. It has a high propensity for persistence and recurrence. Treatment options included voice therapy and antireflux measures. Surgical excision has been considered in patients who do not respond to medical management. In this research, we aimed to present our experience with botulinum toxin injection only.Retrospective case series of a tertiary referral center.Our series consisted of 22 patients, who underwent botulinum toxin injection only as an office procedure to bilateral thyroarytenoid and lateral cricoarytenoid muscles in 2 × 1.25 to 2 × 2.5 U. No other treatment was applied. The cases were followed up for at least 6 months ranging between 6 and 100 months with a mean of 28.Seventeen cases (77%) were cured of their granuloma. Eleven of the cured cases had grade 2, four cases had grade 1, and two patients had grade 3 granuloma.Botulinum toxin A injection only is an efficient treatment modality in contact granuloma, especially for grade 1, 2, and 3 cases, and it can be used as a first-line treatment.