Background: Swallowing difficulties (dysphagia) can be associated with a plethora of neurological diseases representing a life-changing condition and, in severe cases, a life-threatening situation. It is, therefore, crucial that patients and caregivers are aware of its implications to implement the best strategies for safety and functional rehabilitation. Current scales present some limitations in assessing patients' and their caregivers' awareness, making it difficult to evaluate more ecological aspects of dysphagia and hampering the assessment of patients with aphasia, attentional disorders or showing poor compliance. Aim: We endeavoured to develop a novel tool for assessing potential distortions of awareness for dysphagia while mitigating the effect of the aforementioned constraints. Methods and Procedures: Capitalising on current methods to assess lack of awareness (anosognosia), we devised and validated a new scale, the VATA-dysphagia, with healthy volunteers, clinicians and adult neurological patients. A sample of 70 neurological patients presenting with dysphagia and different food intake limitations were asked to rate, on a visual-analogue scale, their difficulties in performing specific tasks. Results: Up to 42% of patients were deemed as anosognosics and 10% fell in the borderline range. Interestingly, in a few cases, the caregivers also showed a lack of awareness of the patient's dysphagia. A rapid identification of similar situations may help to promptly intervene and avoid highly risky situations for the patient. Conclusions and Implications: Anosognosia for dysphagia can be more frequent than expected and the VATA-dysphagia, which does not intend to replace dysphagia assessment scales, offers a reliable and rapid method to assess awareness for different types of swallowing disorders in adult neurological patients. It can also be used to evaluate the caregiver's awareness of the patient's circumstances to help anticipate possible risks and minimise incidents.