Neuromuscular diseases (NMDs) often impair respiratory muscle strength, leading to a weak cough. This can result in ineffective airway clearance, increasing the risk of respiratory infections and complications. Effective management focuses on enhancing cough strength, using techniques such as manually assisted coughing, mechanical insufflation-exsufflation (cough assist devices) and optimising pulmonary hygiene. Early intervention, tailored strategies and ongoing monitoring are key to improving respiratory outcomes and quality of life for individuals with NMD.