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Abstract Introduction Pressure Flow Analysis (PFA) is an established analysis method that objectively assesses swallowing through the use of High-Resolution Manometry and Impedance (HRIM). The aim of this study is to report on the current state of PFA in research and clinical practice by providing an overview of frequently used PFA variables, reference data and psychometric characteristics. Methods A systematic review was conducted using the electronic databases PubMed and Embase. Only original articles published in English describing the application of PFA to pharyngeal HRIM recording in adults, were included. Results Twenty articles were identified as eligible. The most frequently used PFA metrics were UES and pharyngeal contractility related variables, bolus presence time, intra-bolus pressures, distension contraction latency and the swallow risk index for which norm data in both healthy subjects and patient populations were retrieved. Correlations were summarized for PFA and patient characteristics (e.g., age) and clinical variables (e.g., catheter diameter, bolus volume, bolus viscosity). PFA proved to have good reliability (intra and inter-rater reliability, repeated measurement; ICC 0.61 - 0.91), and responsiveness (interventions including, e.g., swallowing maneuvers, drugs, and transcranial direct current stimulation). Discussion PFA is an established analysis method in swallowing. The establishment of norm data and good psychometric properties support the use of PFA as an objective method to assess swallowing and swallowing disorders in daily clinics and research.