Purpose: Cystoscopic intravesical injection of Botulinum toxin A (BTX-A) was approved by the TGA for neurogenic detrusor overactivity (NDO) in 2012, and for idiopathic overactive bladder syndrome (OAB) the following year. This study describes trends in the use of BTX-A in Australia for these indications over the past 10 years. Methods: A retrospective analysis of Medicare Benefits Schedule statistical data for the relevant item numbers (18375, 18379) was performed. Data from financial year 2013-2014 to 2022-2023 were extracted. Patients under 15 years were excluded, and data were analysed by age and sex. Linear regression analysis was performed in R Studio. Results: Over 10 years 24,192 cystoscopic procedures to inject BTX-A were subsidised by Medicare. Despite the item number commencing later, 66% of claims were for OAB. Most procedures were for females (75%) and the most common age group was 65-74 for both indications. Over the past decade there has been increasing per-capita utilisation of claims for both item numbers. Rates were stable in 2019-2020 during the COVID-19 pandemic but continued to increase in 2020-2021. The rate of increased utilisation was higher in females and this was statistically significant for both NDO (p < 0.01) and OAB (p < 0.001). Conclusion: Intravesical BTX-A is an effective and increasingly widespread treatment for NDO and refractory OAB. The presented Medicare Benefits Schedule data is consistent with internationally increased utilisation of this treatment. Higher utilisation in females likely reflects increased efficacy in this group as well as the increased prevalence of bothersome incontinence as a result of NDO or OAB.