The number of lung transplantation (LTx) has recently increased. Dysphagia is a common complication after LTx and can cause severe aspiration pneumonia, particularly in immunocompromised patients. There are very few studies on dysphagia after LTx, especially domestic data have not been reported. This study is to investigate the prevalence and associated factors of dysphagia after LTx by a videofluoroscopic swallowing study (VFSS). Lung transplant recipients from March 2017 to June 2019 were included. Dysphagia was assessed by VFSS to confirm laryngeal penetration and tracheal aspiration. We investigated the duration of tubal feeding, duration of ventilator application, presence of tracheotomy and an intensive care unit acquired weakness (ICUAW). We compared these factors with no penetration/aspiration (PA) group and PA group. All statistical analyses were performed with SPSS software using independent t-test and chi-square test. A total of 33 patients were enrolled and VFSS was performed on average of 22 days after surgery. All patients were in the ICU and received nutrition via nasogastric tube before VFSS. Twenty-three (69.7%) patients showed penetration or aspiration in VFSS. Aspiration showed 50.5% of all patients, of which 84% were aspiration without symptom (Table). In comparison between no PA group and PA group, the presence of tracheostomy and ICUAW was significantly more in PA group (p<0.05). However, age, duration of tubal feeding and duration of ventilator application were not statistically significant between two groups. This is the first study to report the dysphagia of LTx recipients in Korea. We found that the prevalence of dysphagia after LTx was about 70% and the presence of the tracheostomy tube and ICUAW were associated with dysphagia after LTx. In addition, silent aspiration accounted for 84% of tracheal aspiration. For prevention of aspiration pneumonia, diagnostic evaluation of dysphagia after LTx is strongly recommended before starting oral feeding.