Spasticity is a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. As one component of the upper motor neuron syndrome, spasticity remains a vexing problem for both clinicians and patients. Although several medications have been approved for clinical use in patients with spasticity, the literature has yielded no clear standard of care. The aims of this article are to review the mechanisms of spasticity, factors to consider when choosing and starting antispastic drugs in clinical settings, and the typical characteristics and effects of commonly used agents. This review will focus only on enteral medications, not neurolytic or intrathecal therapy.