An empirical observation that the prostaglandin derivate latanoprost quited facial spasms in patients with glaucoma prompted us to study latanoprost in non-glaucomatous patients with hemifacial spasms [HFS]. This explorative trial followed an open-label, prospective treatment design. At short term, most patients showed no or only mild improvement and subsequently needed therapy with Botulinum toxin A. Although these results are not impressive, latanoprost could be considered as an interesting alternative in the treatment of patients with HFS and with concomitant glaucoma. A role for prostaglandins in the trigeminofacial reflex is hypothesised.