Background: The role of glycopyrrolate and other pharmacological drying agents is well established for secretion management in specific populations such as patients living with cerebral palsy or requiring palliative care. Whilst drying agents are used for weaning tracheostomised patients with an acute neurological condition, clinical decision–making pathways have not been well described. To examine the clinical practice of tracheostomy weaning and use of pharmacological drying agents in an acute neurological population admitted to a tertiary hospital. Methods: A retrospective cohort analysis between 2014 to 2019 of all patients tracheostomised after a neurological event. Data were extracted from medical records to obtain patient demographic details, history of presenting condition and weaning plans. Results: A total of 116 patients with a neurological diagnosis required a tracheostomy, of whom 20 patients were using at least one pharmacological drying agent during tracheostomy weaning process. Nine patients still required drying agents on discharge from hospital. Conclusion Patients who required drying agents in their tracheostomy wean demonstrated a trend towards a longer duration of tracheostomy and a longer length of stay than those who did not. Clinicians need to complete patient–centred objective measures regarding swallowing function and saliva management when considering if a drying agent will be required.