Purpose: To evaluate subjective outcomes and preferences in patients with benign essential blepharospasm (BEB) treated with both onabotulinumtox in A (Botox) and incobotulinumtox in A (Xeomin). Methods: An institutional review board approved retrospective review of 128 patients treated with onabotulinumtox in A for BEB by 1 author (J.B.H.). Fifty of these patients were switched to incobotulinumtox in A as an alternate drug. At scheduled follow up, patients decided to continue with incobotulinumtox in A or switch to onabotulinumtox in A. Patient preferences regarding treatment with onabotulinumtox in A versus incobotulinumtox in A were recorded. The preference groups were analyzed using unpaired Student t test, with statistical significance set at p < 0.05. Results: Of the 50 incobotulinumtox in A patients, the mean age was 64.9 years; 39 (78%) were women and 11 (22%) were men. In all, 26 (52%) preferred incobotulinumtox in A and 24 (48%) preferred onabotulinumtox in A. Most frequently, those who preferred incobotulinumtox in A believed that it was "more effective" (N = 10, 29%), whereas those who preferred onabotulinumtox in A concluded that it had a "longer duration" (N = 11, 37%). The mean treatment interval was 13.0 weeks (standard deviation [SD] = 6.39) in those who preferred onabotulinumtox in A, whereas it was 10.2 weeks (SD = 2.15) in those who preferred incobotulinumtox in A (p = 0.017). There was no statistical difference when comparing mean disease duration, number of total treatments, and number of units/treatment between the 2 preference groups. Conclusions: This study demonstrates that patients who prefer incobotulinumtox in A over onabotulinumtox in A had a statistically significant shorter treatment interval. In addition, those who preferred incobotulinumtox in A thought it was more effective, whereas those patients who preferred onabotulinumtox in A thought it had a longer duration. This information can be used when counseling both newly diagnosed and long-standing BEB patients regarding their therapeutic options.