Abstract: Dysphagia is one of the common and serious complications of stroke, traumatic brain injury and other neurological disorders. It can lead to aspiration, aspiration pneumonia, malnutrition and dehydration, substantially affecting patients’ rehabilitation outcomes and quality of life. Vagus nerve stimulation (VNS), as an emerging neuromodulation technique, has shown potential value in dysphagia rehabilitation. Its mechanisms of action may be related to processes such as promoting neuroplasticity, attenuating inflammatory responses, improving blood-brain barrier function, and promoting vascular regeneration. Compared with implanted VNS, transcutaneous auricular vagus nerve stimulation (taVNS) has broader prospects for clinical application because of its advantages of being noninvasive, safe, easy to perform, and associated with good patient compliance. Existing studies have shown that VNS can improve post-stroke swallowing function to some extent; however, limitations remain, including small sample sizes, a lack of standardized stimulation parameters, and insufficient evidence regarding its mechanisms of action. This article reviews the neurophysiological basis, advances in clinical research, and current limitations of VNS in dysphagia rehabilitation, and summarizes emerging neuromodulation strategies such as closed-loop vagus nerve stimulation. On this basis, the potential mechanisms by which VNS improves dysphagia and directions for its precision application are integratively analyzed from the perspectives of neural network remodeling and coordinated peripheral-central regulation, with the aim of providing a reference for future basic research and clinical practice.