Post-stroke sialorrhea is a very debilitating condition that negatively impacts a person's physical and psychological health. In this report, we discuss a case of medication refractory post-stroke sialorrhea in a female patient. The patient received multidisciplinary management and two fractions of radiotherapy over a course of five months. The treatment was successful, and the patient reported satisfactory control of her sialorrhea symptoms. We hope to highlight the importance of multidisciplinary management and consideration of radiotherapy as a treatment modality when providing care for medication refractory poststroke sialorrhea patients who are unsuitable for salivary gland botulinum toxin (BoNT) injection and surgery.