Objective To summarize the rapid identification and nursing experience of 109 patients with botulinum toxin type A injection-related poisoning，and to provide clinical reference. Methods Clinical data of 109 patients with botulinum toxin type A injection-related poisoning admitted to a tertiary occupational disease hospital from July 2024 to September 2025 were retrospectively analyzed. Centered around the core of rapid identification， nursing interventions were implemented along the timeline of disease progression，including rapid identification process based on symptom checklists during hospitalization and safety monitoring of antitoxin administration during the admission phase，respiratory graded monitoring based on warning thresholds and airway clearance during the acute phase，early active and passive rehabilitation training for patients receiving mechanical ventilation during the respiratory failure phase，stepwise swallowing rehabilitation and comprehensive assisted nursing during the recovery phase，and layered narrative psychological support throughout the whole course. Results All 18 patients on mechanical ventilation were successfully weaned，and 84 patients with dysphagia resumed oral feeding. No complications occurred in any patient，and the median hospital stay was 5 days. Conclusion Rapid identification and stratified，dynamic，and individualized nursing interventions for patients with injection-related botulinum toxin type A poisoning can improve rehabilitation compliance，promote functional recovery，and shorten hospital stay.