The purpose of this study was to investigate clinical assessment practices and instrumental examination decision-making by speech and language therapists (SLTs) in Ireland. A 21-question survey (including patient scenarios) was sent to 480 SLTs in Ireland. A total of 261 completed surveys were returned (54%), providing demographic information on SLTs currently working in Ireland and their services. Of these 261 surveys, 70 provided the data for the study, focusing on SLTs currently working in dysphagia, with adults/seniors at least some of the time. The results also showed clinician variability regarding which components are included in a bedside clinical examination of swallowing, with a high degree of consistency for only 11 of the 20 components. Clinicians agreed in their instrumental vs. noninstrumental evaluation recommendations for two of the six patient scenarios, with wide variability in clinical decision-making. Possible influences on clinical decision-making are discussed in relation to the findings of similar previous studies, as well as the current status and future needs of dysphagia training and services in Ireland.