Dysphagia, are very common as people age, and are associated with significant negative outcomes, Functional efficiency, which decreases with age, causes the elderly to lose independence and generates the need for help from others. Therefore, this study aimed to assess swallowing disorder and functional efficiency of hospitalized elderly patients. Design: A descriptive design was used. Setting: The study was conducted at Neurological Department, Zagazig University Hospitals. Sample: A purposive sample consisted of 90 elderly patients. Tools: Three tools were used include; A structure interview questionnaire; it was composed of three parts, Brief Bedside Dysphagia Screening Test - Revised (BBDST-R), and Barthel Index (BI). Results: the age of study subjects ranged between 60 to 81 years and the mean age of them was 66.76± 5.80 years, with more male 56.7%, also, 60.0 % of the studied elderly patients have normal swallowing, and 40.0 % of them have abnormal swallowing, there are 23.3 % of the studied elderly patients were independent in daily living activity, 21.1% of them were need minor help, 43.3% of them were need major help and 12.2% of them were totally dependent. Conclusion: less than half of the studied elderly patients had swallowing disorder, and the others had normal swallowing. Additionally, less than third of them were need minor help, and nearly half of them were need major help. Moreover, there was a statistically significant negative correlation between swallowing disorder score and functional efficiency score. Recommendation: Replicate the study on a larger group; selected from different geographical areas in Egypt to obtain more generalized findings in relation to current study.