Neurodegenerative diseases are progressive degenerations of the brain with increasing movement disorders, like gait, speech and swallowing disorders combined with cognitive disorders, like dementia. Neurodegenerative diseases have in common that aspiration pneumonia is the most frequent cause of death in the end-stage of the disease. This article provides an overview of the prevalence, characteristics and treatments of oropharyngeal dysphagia resulting from multiple system atrophy (MSA), progressive supranuclear palsy (PSP), Huntington's disease (HD), multiple sclerosis (MS) and dementia. The prevalence of dysphagia ranges from 32% in MS, 57% in patients with dementia to 73% in patients with MSA and almost 100% in patients with PSP or HD. Treatment is aimed at swallowing with less effort, swallowing more safely and/or optimal nutritional intake. When cognitive decline and behavioural changes increase, passive compensations like food adaptations and comfortable mealtime conditions become the principal interventions.