Objective To construct a clinical decision support system for dysphagia after stroke, and to evaluate its application effect in the identification, prevention and control management of dysphagia after stroke. Methods Patients with acute ischemic stroke were randomly selected and divided into two groups chronologically,the 33 patients admitted from July to September 2023 (before the system was applied) were taken as a control group, and the other 33 patients admitted from October to December 2023 (after the system was applied) were regarded as an intervention group. On the basis of routine care, the control group experienced Modified Water Swallow Test, then they were given targeted dietary guidance, oral feeding safety education and dynamic evaluation of swallowing function for dysphagia according to the screening results. While in the intervention group, the clinical decision support system for dysphagia after stroke (built based on computer language and database model, including five modules:early warning screening, intelligent assessment, risk warning, decision analysis, evaluation and reminder) was used to screen and evaluate patients′ dysphagia, then targeted nursing intervention was accordingly implemented. Before and after application of the system, the screening rate of patients′ swallowing function, the accuracy of screening results, the scores of nurses′ swallowing disorder management knowledge and behavior, and the application experience of clinical nurses were evaluated. Results The swallowing function screening rate in the intervention group were significantly higher than those in the control group, after application of the system, the scores of swallowing disorder management knowledge and behavior of clinical nurses were significantly higher than those before application of the system (all P<0.05). The total score of clinical nurses′ application experience of the system was 99.40±4.81. Conclusion The constructed clinical decision support system for dysphagia after stroke can assist nurses to make online decisions, standardize the management behavior of dysphagia, enhance the screening rate of dysphagia in stroke patients, and effectively implement dysphagia prevention and control measures, then improve the quality of dysphagia management after stroke, and ensure the safety of patients.