Background: Videofluoroscopic swallow studies (VFSS) are multidisciplinary swallowing assessments led by speech-language therapists (SLTs). The purpose of oesophageal screening in VFSS is to guide further diagnostic assessment and treatment of possible oesophageal abnormalities. Yet, internationally standard protocols and clinical pathways for oesophageal screening in VFSS have not been established. Aim(s): The aim of this study was to refine and optimise oesophageal screening in VFSS at one Australian metropolitan hospital by incorporating expertise of the multidisciplinary dysphagia team. Methods and Procedures: Focus groups/semi-structured interviews were conducted with SLTs, radiologists (RADs), gastroenterologists (GEs), referring medical officers (MEDs) and medical radiation technicians (MRTs, also known as radiographers) working in VFSS. Interview questions explored oesophageal screening approaches, interpretation and reporting practices, GE referral criteria and clinical recommendations. Data were analysed via qualitative content analysis to determine meaning units, sub-categories, and categories. Outcomes and Results: Twenty-six health professionals were interviewed (n = 8 SLTs, n = 6 RADs, n = 5 MEDs, n = 4 MRTs, n = 3 GEs). Four categories were identified: (1) oesophageal screening in VFSS adds clinical information but has limitations; (2) specific knowledge, skills and organisational factors are needed to optimise oesophageal screening, including in procedure, interpretation, reporting, GE referral pathway and intervention selection; (3) multidisciplinary consensus is needed regarding normal versus abnormal oesophageal transit and GE referral criteria; and (4) patient context, preferences and reported symptoms should primarily guide dysphagia decision-making. Each category had several component subcategories. The local clinical pathway (also known as care pathway or care map) for oesophageal screening in VFSS was refined by incorporating multidisciplinary dysphagia team expertise. Conclusions and Implications: There was a willingness from the multidisciplinary dysphagia team to refine the local clinical pathway for oesophageal screening in VFSS. Detailed clinical pathways that guide workflow and decision-making should be considered when introducing oesophageal screening into VFSS protocols.