Purpose: This study aims to evaluate the changes in soft tissue thickness of the masseteric region after injection of botulinum toxin type A (BTX-A). Methods: Twenty-four data acquired from medical records were classified into 4 groups: bruxer group that received masseter muscle injection only (M-B), bruxer group that received both masseter and temporalis muscle injections (MT-B), non-bruxer group that received masseter muscle injection only (M-NB) and non-bruxer group that received both masseter and temporalis muscle injections (MT-NB). Injection dose of BTX-A was 30 units for each masseter muscle and 20 units for each temporalis muscle. We measured the reduced thickness of the masseteric region before and after 12 weeks after injection using cone-beam computed tomography. Results: Among the patients that received both masseter and temporalis muscle injections, bruxer group showed a tendency to have more reduction in masseter muscle thickness than non-bruxer group. The difference in reduced thickness between M-B and MT-B tended to show greater than the difference between M-NB and MT-NB. Conclusions: In case of masseter hypertrothy patients with bruxism there was a tendency to show a difference in reduced thickness of soft tissue between the group that received both masseter and temporalis muscles injection and the group that received masseter muscle injection only hence a thorough inspection before the injection of BTX-A is condisered to be needed.