Purpose: This study aims to analyze the effects of prophylactic swallowing exercise (PSE) applied to head and neck cancer patients undergoing radiotherapy to utilize the characteristics of the interventions used in the research as a basis for application in clinical practice. Methods: The systematic searches were conducted up to November 15, 2023, from four databases (PubMed, EM base, Cochrane, CINAHL). The included studies were assessed using the Revised Cochrane Risk-of-Bias tool, and we followed the Preferred Reporting Items Systematic Reviews and Meta-Analysis guidelines. Results: Seven randomized controlled trials meeting criteria were identified. These trials applied various interventions. Some studies demonstrated statistical significance in intake status, swallowing function status, videofluoroscopic swallow study and quality of life, but they could not specify the characteristics of the most effective intervention for the participant. Conclusion The prophylactic and individualized swallowing exercises are crucial. Strategies to increase compliance rates should be explored. Additionally, diverse research related to this topic should be conducted.