Objective To explore the characteristics and mechanisms of dysphagia in patients with dorsola-teral medullary syndrome ( DMS). Methods Twelve DMS patients were evaluated clinically and submitted to videofluoroscopic study in order to investigate clinical manifestations and the pathophysiological changes in swallowing. Swallowing function was recorded at discharge and during a three-month follow-up period. Results All patients had difficulties in swallowing and drinking, presenting coughing and throat clearing, and needed nasogastric feeding at admission. Insufficient soft palate elevation was observed in seven patients, who had no other oral phase dysfunction. The pharyngeal phase was injured in all patients. Decreased larynx elevation and invalid swallowing were observed in 10 patients. Delayed pharyngeal swallowing was seen in 8 patients. Under videofluoroscopy, 9 patients showed significantly decreased larynx elevation. Ten patients opened the cricopharyngeal muscles insufficiently, while two could not open at all. Larynx penetration was seen in all patients. Eleven patients were able to return to oral feeding, after 36 days on average (range 13 - 50 d). The patients with a disease history of 3 or more years could not return to oral feeding. Conclusion DMS patients are characterized by decreased larynx elevation and reduced compliance of the cricopharyngeal muscles. Early therapy may provide patients with a good prognosis.