Epiglottic movement patterns of 500 consecutive patients with varying etiologies were recorded during routine video¯uoroscopic swallow evaluations. Seven distinct, commonly repeated, abnormal epiglottic patterns were identi®ed. A multifactorial analysis of these seven abnormal epiglottic movement patterns was completed. Findings indicate that each of these seven distinct movement patterns have varying rates and amounts of aspiration. A description of each epiglottic movement pattern is given in conjunction with information regarding aspiration and other variables associated with the swallow process. A universal nomenclature is oered regarding these subtle abnormal epiglottic movement patterns to increase a verbal commonality in our descriptions of epiglottic function as it aects aspiration.