Dysphagia is the disruption of the normal swallowing process; its epidemiology is a national health care concern. Dysphagia affects as many as nine million Americans. Understanding normal swallowing mechanics and how they may be disrupted is a vital patient safety goal in rendering care during the perianesthetic period. The diversity of patients and perianesthetic conditions that may cause or exacerbate existing dysphagia requires that a heightened index of suspicion be maintained. In this continuing education article for perianesthetic nurses, we review normal swallowing, pathophysiologic perturbations in the swallowing process, and drug-related impairments.