Swallowing dysfunction is one of the common complications of stroke, mainly seen in patients with bulbar palsy and pseudobulbar palsy, and transient swallowing dysfunction can also occur in patients with unilateral cortical brainstem bundle damage, with an incidence of 16% to 60%. The main manifestations are difficulty in eating, choking and dysphonia. Patients may suffer from water and electrolyte disorders and other nutrient deficiencies due to inadequate intake, and may even experience a decrease in albumin. Aspiration pneumonia and even asphyxiation can be easily caused by accidental ingestion of food into the airway. Swallowing dysfunction can be simply screened by drinking test and saliva test to observe whether there is choking or not, and the trigeminal nerve, facial nerve, linguopharyngeal nerve, vagus nerve and hypoglossal nerve should also be checked for abnormalities, or for video fluorescence imaging. Because about 30% to 40% of patients with swallowing disorders do not have choking cough. When swallowing dysfunction occurs, for those with consciousness impairment, nasal feeding and infusion can be used first to supplement nutrition, while muscle contracture of the neck should be prevented. When the patient is conscious, stable and able to obey instructions, the corresponding examination and training will be carried out. After systematic rehabilitation training, most of the patients can resume eating ordinary diet through mouth. Usually, the rehabilitation training methods are as follows: 1. Indirect swallowing training When the patient is clear and can sit steadily, the following training can be started. Training to improve the pharyngeal reflex can be done by repeatedly stimulating the soft palate and posterior pharyngeal wall with frozen wet cotton swabs. Closure of the vocal cords exercise allows the patient to say “ah” out loud. This exercise trains the patient to close the vocal cords at will and is effective in preventing aspiration. Supraglottic swallowing This is a set of training actions that allows the patient to inhale fully, hold it, then slowly swallow saliva, then exhale, and finally cough. This is trained by using the principle of vocal fold closure when stopping breathing, and the final cough is to remove the remaining food around the larynx. It is suitable for patients whose swallowing process causes misopharynx. 2. Direct feeding training When the patient is clear, stable, has gag reflex and can cough at will, you can practice feeding. At the beginning of the feeding practice, the patient is usually placed in a semi-recumbent position with the head slightly tilted forward. In hemiplegic patients, the patient can be placed in a lateral position with the healthy side underneath, and the neck is slightly flexed forward, which can easily cause the gag reflex and reduce misophagy. In addition, rotation of the patient’s neck to the affected side can reduce the residual food in the pharynx. The food used for feeding training should be homogeneous jelly or paste food, such as egg custard, batter, etc., which can be easily moved in the mouth and not easily swallowed, taking into account the patient’s preference and nutritional composition. Because liquid food is easy to move in the oral cavity, but it is weak to stimulate the pharynx and prone to mispharynx. Solid food is easy to stimulate the pharyngeal reflex and less misopharyngeal, but requires full chewing and does not easily move to the pharynx. Therefore, patients can use foods such as egg custard and batter for initial training, and gradually transition to eating a normal diet and water. When training, the amount of food to be eaten in one bite is 1 small tablespoon, the speed of eating should not be too fast, and after each bite, the patient should be allowed to swallow several times repeatedly. In addition, oral care should be performed regularly to prevent food residues from remaining in the mouth. To prevent accidental aspiration due to esophageal reflux, patients should remain seated for more than half an hour after a meal.