Swallowing is a coordinated process with four distinct phases: oral preparatory, oral propulsive, pharyngeal, and esophageal. Disruption in any phase, termed oropharyngeal dysphagia (OD), can arise from neuromuscular, rheumatologic, immunologic, or endocrinologic disorders. These conditions contribute to OD through mechanisms that impair muscle function and coordination, most prevalent among elderly and neurologically compromised patients. OD manifests with symptoms like coughing, choking, prolonged meal times, and sensations of food lodging in the throat, signifying risks to both swallowing safety and efficiency. Diagnosing OD involves clinical assessment, symptom history, and instrumental testing. Key diagnostic tools include the volume-viscosity swallow test (V-VST), fiberoptic endoscopic evaluation of swallowing (FEES), videofluoroscopic swallowing study (VFSS), and high-resolution pharyngeal manometry (HRPM). V-VST offers a preliminary assessment to guide further diagnostics. FEES and VFSS are gold standard imaging methods for evaluating anatomical and functional swallowing deficits, while HRPM provides detailed metrics on pharyngeal contractility and upper esophageal sphincter (UES) function. HRPM, uniquely capable of identifying motor function irregularities, aids in tailoring treatments. Each method contributes valuable insights, supporting individualized management and enhancing therapeutic outcomes for patients with OD.