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Jennifer M Cori,1 Fergal J O’Donoghue,1 Amy S Jordan2 1Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Austin Hospital, Heidelberg, VIC, Australia; 2Department of Psychology, Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia Abstract: The focus of this review was on the genioglossus (GG) muscle and its role in maintaining upper airway patency in both healthy individuals and obstructive sleep apnea (OSA) patients. This review provided an overview of GG anatomy and GG control and function during both wakefulness and sleep in healthy individuals and in those with OSA. We reviewed evidence for the role of the GG in OSA pathogenesis and also highlighted abnormalities in GG morphology, responsiveness, tissue movement patterns and neurogenic control that may contribute to or result from OSA. We summarized the different methods for improving GG function and/or activity in OSA and their efficacy. In addition, we discussed the possibility that assessing the synergistic activation of multiple upper airway dilator muscles may provide greater insight into upper airway function and OSA pathogenesis, rather than assessing the GG in isolation. Keywords: pharyngeal dilators, upper airway, airway obstruction, airway collapsibility and sleep