Dysphagia may in rare instances be a presenting feature of unilateral cerebral lesions. Normally, bilateral lesions are necessary to cause neurological disturbance of swallowing but there appear to be occasional subjects where this is not so. Cases are presented and the literature reviewed to illustrate this. The dysphagia may occur in isolation and is not necessarily accompanied by dysarthria, facial apraxia, or obvious paralysis. The lesion may be on either side and usually involves the low posterior frontal region. Cases that have come to necropsy have shown involvement of the lowest part of the precentral gyrus or the posterior part of the inferior frontal gyrus.