The usual indications for gastrostomy include the need for feeding, decompression, or gastric access. In feeding situations, the gastrointestinal tract must be functional and the need for enteral feeding must be for a prolonged interval. Stamm gastrostomies are most commonly performed at the conclusion of some other major gastrointestinal procedure while the abdomen is open, However, the percutaneous endoscopic gastrostomy (PEG) allows the placement of a gastrostomy in adults and children without laparotomy. This technique depends upon the safe passage of an endoscope into the stomach, which can be dilated with air. Inability to pass the endoscope safely or inability to identify the transabdominal lumination of the lighted endoscope tip within the dilated stomach are contraindications to the procedure. Ascites, partially corrected coagulopathy, and intra-abdominal infection are relative contraindications to the PEG method.