Objective To explore the effect of feeding management based on the volume-viscosity swallow test for dysphagia patients with neurological diseases. Methods A quasi-experimental research design was utilized, and the dysphagia patients with neurological diseases were selected and divided into a control group (n=47) and an observation group (n=61) chronologically. The control group received routine nursing, the patients with grade 2 in Water swallow test were given dietary guidance, and the patients with grade 3 or above were indwelled with gastric tube and were given tube feeding, while the observation group were additionally assessed for the risk of dysphagia according to the volume-viscosity swallow test, then received individualized feeding based on the assessment results. Results The implementation rate of tube feeding in the observation group was significantly lower than that of the control group（24.59% vs.44.68%,P＜0.05）, the tube retention time was significantly shorter than that of the control group （10.13 days vs.14.05 days, P＜0.05）, and the incidence of aspiration signs for the patients with oral feeding was significantly lower than that of the control group (17.39% vs. 42.13%,P＜0.05）. Conclusion The feeding management based on the volume-viscosity swallow test could provide a precise feeding plan for dysphagia patients, decrease unnecessary tube placement, shorten tube feeding time, and ensure feeding safety.