The finding of pooling of secretions is an important diagnostic finding in the evaluation of subjects with swallowing disorders. In patients at risk of aspiration the importance of this finding may be underestimated. We stress the usefulness of endoscopic investigation when evaluating subjects with swallowing disorders, or populations at risk for dysphagia, as well as for follow-up and management. Pooling, in global terms, is a significant criterion both for grading the severity of dysphagia, and providing indications for targeted referral to a speech therapist, and while tracking the disorder over time. The severity of dysphagia is expressed by scores that can consider endoscopic landmarks alone, or along with other parameters of bedside evaluation. The scores are represented by a simple number which refers to three degrees of severity: mild, moderate, and severe.