Little objective documentation is available regarding the efficacy of therapies for oropharyngeal dysphagia. Information specifying efficacy of treatment for chronic dysphagic conditions is almost nonexistent. This report describes a direct therapy program for chronic neurogenic dysphagia resulting from brainstem stroke, and provides information on immediate and long-term clinical outcome. Changes in swallowing physiology reflect goals of therapy. Long-term follow-up shows that functional benefits are long lasting without related health complications.