Objective To study the value of pharyngeal reflex examination combined with dynamic swallowing study (DSS) and analyze the water swallowing test (WST) in the diagnosis of dysphagia and the screening of aspiration in patients with post-stroke dysphagia, clarify the common risk factors of dysphagia, and dynamically assess the swallowing function of patients.Methods Based on the pharyngeal reflex examination, stroke patients were categorized into 2 groups: normal pharyngeal reflex group and abnormal group (diminished or absent). WST and DSS were performed in the 2 groups. Patients' swallowing in the pharyngeal phase was evaluated using the videofluoroscopic dysphagia scale (VDS) score (pharyngeal phase), and related risk factors were analyzed. Results The differences in gender, age, duration of disease, and type of stroke were not statistically significant (P＞0.05). The difference in sensitivity of the WST in diagnosing dysphagia and screening for malabsorption between the 2 groups of patients was statistically significant (P＜0.05), and the difference in specificity was not statistically significant (P＞0.05). Dynamic swallowing imaging was more intuitive in the assessment of pharyngeal phase infiltration, pearly fossa residue, and epiglottic valley residue, with the incidence of infiltration in the normal pharyngeal reflex group being 19.2%, the incidence of pearly fossa residue 26.7%, the incidence of epiglottic valley residue 23.3%. The incidence of infiltration in the group with abnormal pharyngeal reflexes was 26.3%, the incidence of pearly fossa residue 35.0%, and the incidence of epiglottic valley residue 33.8%. The dilute fluids were more susceptible to aspiration than semi-fluid and pasty substances; pasty substances and semi-fluid substances were more susceptible to residual residue than dilute fluids. With the growth of age, the incidence of dysphagia in the patients after stroke increased, and the patients were with previous. The incidence of dysphagia was higher in patients with a history of smoking and choking. Univariate and multifactorial logistic regression analyses showed that age, history of smoking and history of choking were independent influences causing dysphagia after stroke (P＜0.05). Conclusion When the patient's pharyngeal reflex function is abnormal, the sensitivity of the Kubota drinking test is low, and there is a possibility of hidden aspiration, which is less safe. Therefore, when the pharyngeal reflex is abnormal, dynamic pharyngography can be used directly in patients with complaints of dysphagia, so that the insecurity of the Kubota drinking test can be avoided. Exhortation of the patient to quit smoking, and comprehensive guidance on the patient's diet are important