Respiratory muscle dysfunction is a common complication of stroke, which can lead to decreased strength and atrophy of the respiratory muscles, increased incidence of pulmonary infection, and increased risk of non-vascular death in patients. This paper reviews the mechanisms, main assessment methods, and rehabilitation approaches for respiratory muscle dysfunction in stroke patients, in order to provide references for clinical rehabilitation and research on respiratory muscle dysfunction in stroke patients. The analysis shows that stroke can cause respiratory muscle dysfunction due to primary lesions in the central nervous system, secondary neuromuscular injury, and iatrogenic injury; commonly used clinical assessment methods include ultrasound, peak cough flow, pulmonary ventilation function tests, respiratory mechanics indexes measurement, electrophysiological examination, etc. Acoustic analysis can be used as one of the future visualization assessment and guidance for respiratory rehabilitation. Commonly used clinical rehabilitation approaches include external diaphragm pacing, neuromuscular electrical stimulation, proprioceptive neuromuscular facilitation, airway management, respiratory muscle training, etc. The electric standing bed can be used as one of the means to prevent infection and improve respiratory muscle function in critically ill patients.