<p>Neurogenic dysphagia is a common complication of neurological disorders, significantly increasing the risk of aspiration pneumonia and morbidity. This study aims to characterize swallowing dysfunction in patients with neurogenic dysphagia using fibreoptic endoscopic evaluation of swallowing (FEES). A total of 60 patients with neurogenic dysphagia were assessed at St. John’s Medical College and Hospital between March 2019 and January 2022. Clinical characteristics, vocal cord function, and FEES findings, including penetration-aspiration scores (PAS) and residue distribution, were analysed. Cerebrovascular accident was the most common underlying condition (75%), followed by Parkinson’s disease and myasthenia gravis. FEES findings indicated a higher incidence of aspiration with liquids (36.7%) than solids (14.8%), with pyriform sinus residue being associated with higher PAS scores and increased aspiration risk. Vocal cord dysfunction was present in 15 patients, who exhibited significantly higher PAS scores. These findings emphasize the importance of individualized dysphagia management strategies, including dietary modifications and rehabilitative interventions. FEES serves as a valuable tool in identifying aspiration risk and guiding therapy to improve swallowing safety. FEES also serves as a biofeedback tool for targeted rehabilitation strategies and follow-up care.</p>