Background: Swallowing difficulties are common after stroke and can lead to respiratory problems, pneumonia and malnutrition. It is essential in the management of swallowing difficulties, that the patient is assessed as early as possible. For this purpose there is a need for a proper screening method. Purpose: To find evidence to support the clinical use of the water swallowing test as a screening tool. Method: A search was performed in Medline, EMBASE, CINAHL, among others. Results: The water swallowing test should consist of a preliminary assessment of the patient’s ability to participate, and a direct test of the swallowing, using small quantities of water. The best indicators for swallowing difficulties, when using the water swallowing test, are poor conscious level, latent swallow and coughing during or after the swallow. Conclusion: The water swallowing test is a simple and relatively valid screening tool and can easily be implemented in clinical settings.