Key Points 1. Sialorrhea is a common condition affecting both children and adults with neuromuscular disorders including cerebral palsy, Parkinson's disease, amyotrophic lateral sclerosis, and other neurodegenerative disorders. 2. Sialorrhea is a highly distressing problem that can lead to significant psychological, social, and medical issues. 3. A multidisciplinary approach involving speech therapy, neurology, otolaryngology, and others is advisable to help with the complex decision-making process. 4. In most cases, noninvasive therapeutic modalities such as physiotherapy and systemic medication should be explored prior to more invasive therapies such as the injection of botulinum toxin and surgery. 5. There is no consensus as to the best surgical procedure to treat sialorrhea. Procedure selection should be guided by patient characteristics including severity of drooling, presence of aspiration, and overall medical condition. It is imperative to give patients and their families clear expectations of treatment.