Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder of unknown etiology that affects upper and lower motor neurons resulting in progressive atrophy of skeletal muscles. There are two forms of ALS: spinal motor neuron injury and bulbar paresis. Dysphagia is a highly prevalent severe and invalidating symptom in ALS: almost 80% of ALS patients with bulbar paresis will develop dysphagia. Also, dysphagia is one of the most common and serious complications, with respiratory insufficiency, in patients with ALS as it exposes them to malnutrition, dehydration and aspiration pneumonia. These conditions are reported to be associated with a minor survival in patients with ALS. Screening for dysphagia must be performed in all ALS patients at diagnosis and during the follow-up to approach dysphagia as soon as possible. This chapter includes the latest developments in the assessment and approach of dysphagia in ALS patients.