Dysphagia is a common symptom in acute stroke. However, stroke-related dysphagia usually improves faster than other neurologic symptoms. Therefore, in addition to early diagnosis of dysphagia, closely meshed monitoring is necessary to guide appropriate protective and nutritional strategies. We propose serial fiber-optic endoscopic evaluation of swallowing as a valuable tool for this purpose. The clinical impact of serial fiberoptic endoscopic evaluation of swallowing is exemplified by reporting on a patient with a complicated course of stroke-related dysphagia.