Symptoms of pharyngeal/esophageal diseases are mainly related to swallowing function, e.g., dysphagia, aspiration, globus sensation or heartburn. Dysphagia and aspiration may lead to malnutrition, potentially life-threatening pulmonary complications (e.g., aspiration pneumonia) and impairment of life-quality. The most important dysphagia related symptom is aspiration. Other components of dysphagia are drooling, leaking, delayed triggering of the swallowing reflex, retentions, nasal penetration or pharyngeal regurgitation. The etiologies of oropharyngeal dysphagia may be divided into three groups: diseases of the upper aerodigestive tract, neurological diseases and psychogenic disorders. Possible hints to suspect dysphagia and aspiration are indirect and direct symptoms. They necessitate an interdisciplinary diagnostic work-up for revealing etiology and pathophysiology. For the proof or exclusion of aspiration it´s direct visualization by videoendoscopy and videofluoroscopy remains indispensable and cannot be replaced by screening procedures.