Objective: The purpose of this study was to conduct a critical analysis of the current treatments for upper-limb post-stroke spasticity. Methods: Using search terms including spasticity, stroke, hemiplegia, phenol, baclofen, tizanidine, dantrolene, benzodiazepine, and botulinum toxin, the databases MEDLINE, EMBASE, and Cochrane Controlled Trials Register were used to identify studies in English published from 2004-December 2007. Citations of the extracted articles were reviewed to identify any further articles not captured through the database search. Articles were excluded for the following reasons: lower extremity treatments, pediatric studies, commentaries, duplicate studies, and those that focused on the use of treatments for spasticity secondary to a non-stroke etiology (e.g. multiple sclerosis, cerebral palsy, etc.). Results: A total of 34 studies were reviewed and assessed using the Oxford Levels of Evidence quality scale. Fourteen clinical trials, two pooled analyses, two meta-analyses, one cost-effectiveness study, two retrospective cohort studies, three case reports/case-series, five systematic reviews, and five non-systematic reviews were identified. Thirty-one studies focused on botulinum toxin. All clinical trials compared botulinum toxin to either placebo or no treatment. Eleven studies followed patients through one treatment cycle (generally, 12-16 weeks) to determine the duration of treatment efficacy. Three clinical trials completed multiple treatment cycles which lasted 24-42 weeks. Most clinical trials measured spasticity in multiple locations of the arm, such as the fingers, wrist and shoulder. All studies used multiple outcome measures, including instruments that assessed spasticity, pain, quality of life, disability, and functional status. All clinical trials showed a significant difference in spasticity when botulinum toxin was used, as compared either to baseline measurements or placebo. Conclusion: This analysis showed that botulinum toxin effectively reduces upper-limb spasticity in post-stroke patients. Despite utilization of broad search criteria, no current trials demonstrating the efficacy of other treatments were identified.