Swallowing dysfunction (dysphagia) affects 500,000 children and 9 million adults in the US annually. Dysphagia can result in life-threatening choking episodes and aspiration pneumonia, the leading cause of death in children with cerebral palsy, and in adults with stroke and Parkinson’s Disease. Current clinical practice of dysphagia evaluations mainly relies on invasive x-ray videos accompanied with barium liquid intake, uncomfortable endoscopes placed through the nose, non-swallow-specific surface electromyography (sEMG), or haptic perception of a swallow using three fingers along the larynx. None of current available devices could be used to meet patients’ need for 24/7 swallow monitoring and online diagnosis. The developed wearable swallowing measurement device includes a fabric collar with knitted-in strain sensors, hardware & firmware for wireless signal acquisition, transmission and display, and a software app compatible with computers or smart phones for swallow monitoring and diagnosis. This device adopts new technologies in fabric sensing and IoT to form a user-friendly smart device for vulnerable patients with dysphagia, resulting from conditions such as stroke or Parkinson’s disease. Pilot tests on human subjects indicate that accuracy of identifying swallow movement is over 85%. The new technology will provide a noninvasive and unobtrusive testing procedure for dysphagia patients and a low-cost, easy-to-use clinical device for healthcare providers in needs for remote monitoring, clinical diagnosis and screening, and pharyngeal rehabilitation.