The head lift exercise (HLE) is a head-raising workout performed in a supine position. This exercise facilitates activation of the submental muscles located above the hyoid bone in front of the neck. HLE is a potential method to improve the movement of the hyolaryngeal movement and swallowing functions. The purpose of this study was to investigate the effect of HLE on the hyolaryngeal movement and aspiration in patients with dysphagic stroke. A total of 27 patients with stroke were randomly assigned either into the experimental (n = 13) or the control group (n = 14). The experimental group performed HLE 5 days a week for 4 weeks (a total of 20 sessions). Both groups received the same conventional dysphagia therapy. Two-dimensional analysis of the hyolaryngeal movement was carried out using Image J program based on a videofluoroscopic swallowing study. Penetration-aspiration was assessed using Penetration-Aspiration Scale (PAS). The experimental group showed a significant increase in the only superior movements of the hyoid bone compared with the control group (P = 0·033). Aspiration in liquid also exhibited a significant decrease in the experimental group compared with the control group (P = 0·044). Findings from this study confirmed that HLE is an effective intervention to improve hyoid movement and decrease aspiration.