A technique of percutaneous endoscopic gastrostomy was evaluated in 51 children and young adults aged 4 months to 26 years (mean, 9.7 years). Indications for gastrostomy included malnutrition secondary to cystic fibrosis, severe CNS disease, and others. The procedure was performed in 26 patients using local and topical anesthesia. General anesthesia was employed in children under 8 years of age. Duration of operative procedure ranged from 20 to 60 min. The average time for maintenance of feeding gastrostomy was 5.6 months. No procedure-related deaths were observed. Significant complications occurred less frequently than with traditional gastrostomy. We conclude that this procedure is technically simpler than, and at least as safe as, other methods of gastrostomy. It is especially useful in children for whom general anesthesia is best avoided.