Aims <p>Patients with TBI often exhibit concurrent impairments in cognitive function, alertness, and respiratory status, which may further complicate their swallowing abilities. This study investigates the correlation between cognitive function, alertness, and respiratory status with severity of swallowing disorders in patients with traumatic brain injury (TBI) admitted to the intensive care unit.</p> Materials and methods <p>This research was cross-sectional, descriptive-analytical. Sampling was done by the non-probability method. The study sample consisted of 67 traumatic brain injury patients with swallowing disorders hospitalized in the intensive care unit of Tehran hospitals following a brain injury. Then, the correlation between these patients’ alertness, cognitive status, respiratory status, and swallowing disorder was investigated. The Mann Assessment of Swallowing Ability test evaluated swallowing disorder severity. The Glasgow Coma Scale test checked the level of consciousness, the Rancho Los Amigos test checked the cognitive status, and the respiratory status was checked by calculating the number of days of ventilator use.</p> Results <p>The findings of this study indicate that the Rancho Los Amigos score and the Glasgow Coma Scale score have a positive correlation with the MASA score, while the number of days on the ventilator has a negative correlation with the MASA score (P-value &lt; 0.05).</p> Conclusions <p>The findings indicate that cognitive function, alertness, and respiratory status significantly influence safe swallowing in patients with traumatic brain injury in the intensive care unit. Therefore, comprehensive evaluations of these factors are essential for prognosis and for the effective management and treatment of swallowing disorders in this patient population.</p>