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Pulmonary aspiration syndromes are a common cause of morbidity and mortality. These syndromes are often misdiagnosed and their management is frequently suboptimal. This paper reviews the clinical features and management of the most common aspiration syndromes.Pulmonary aspiration syndromes refer to a group of pulmonary diseases resulting from aspiration of foreign material into the lung. The type of syndrome depends on the quantity and nature of the aspirated material as well as its chronicity. The most common syndromes include aspiration pneumonia, diffuse aspiration bronchiolitis, and aspiration pneumonitis. Aspiration pneumonia and diffuse aspiration bronchiolitis generally occur in elderly, debilitated patients with dysphagia and usually present as ‘community acquired pneumonia’, which tends to be recurrent in patients with diffuse aspiration bronchiolitis. Treatment consists of broad-spectrum antibiotics and management of the underlying dysphagia. Aspiration pneumonitis follows the aspiration of gastric contents, usually in patients with a marked decreased level of consciousness. Treatment of aspiration pneumonitis is essentially supportive; however, corticosteroids and other immunomodulating agents may have a role in these patients.Aspiration syndromes are common with their management dictated by the type of aspiration syndrome.