This chapter presents a comprehensive anatomical analysis of the neuroanatomical and physiological mechanisms underlying swallowing and airway protection. The complex coordination between voluntary and involuntary processes, enabling safe deglutition while preserving respiratory function, forms the foundation of this discussion. The anatomical framework examines the intricate relationships between the oral cavity, pharynx, larynx, and esophagus, emphasizing their structural organization and functional significance in the swallowing process. The text provides a detailed examination of the muscular systems, with particular emphasis on the intrinsic and extrinsic muscles of the larynx and their critical roles in airway protection and phonation. The three-level sphincteric mechanism of laryngeal protection receives special attention, along with the coordinated movement of the hyolaryngeal complex during swallowing. This chapter elaborates on the functional anatomy of the upper and lower esophageal sphincters and the mechanisms governing esophageal peristalsis. Neurological control of swallowing is extensively explored, highlighting the crucial functions of various cranial nerves, particularly the vagus, glossopharyngeal, and hypoglossal nerves. The discussion encompasses both central nervous system control and autonomic innervation patterns, emphasizing their importance in orchestrating the complex sequences of swallowing. The integration of respiratory and swallowing functions receives particular attention, focusing on the timing and coordination of swallow apnea and airway protection mechanisms. Throughout this chapter, clinical implications are addressed, connecting anatomical and physiological principles to potential pathological conditions affecting swallowing function. The temporal characteristics of swallow apnea and their variations with age, bolus volume, and viscosity are examined. The text concludes with a detailed analysis of airway protection mechanisms during swallowing, emphasizing the precise coordination required between various anatomical structures and neurological systems for safe and efficient deglutition.