Introduction: In acute stroke dysphagia is a common complication associated with a risk of pneumonia and mortality. The primary aim of our study was to assess the incidence of dysphagia in acute stroke patients and analyze the benefits of early screening and management. Materials and methods: A prospective cohort study was conducted in our center. A total of 100 acute stroke patients were seen. All patients were then assessed by Mann assessment of swallowing ability (MASA) for the presence of dysphagia and aspiration. Patients with dysphagia were then further evaluated by fiber-optic-endoscopic evaluation of swallowing (FEES), stroke severity was assessed by National Institutes of Health Stroke Scale (NIHSS) score and location of stroke was done on the basis of CT scan of the brain. Results: Dysphagia was seen in 53 patients of acute stroke. FEES and swallowing therapy were done in 39 of dysphagia patients. The 3 parameters considered in FEES were penetration aspiration scale, secretion rating scale and residue rating scale. In patients with mild dysphagia compensatory strategies were given whereas in patients with moderate to severe dysphagia both compensatory and rehabilitative were given. Improvement was seen in our patients after swallowing therapy. Conclusion: The incidence of dysphagia in acute stroke patients was 53%. MASA scale helped in early detection of dysphagia. FEES and appropriate swallowing therapy played a significant role in improving the outcome of our patients.