Twenty-five percutaneous gastrotomies and nine percutaneous gastrojejunostomies were performed in 24 children aged 4 months to 22 years. Indications for percutaneous gastrostomy included severe injury to the central nervous system (nine patients), malignancy (seven patients), failure to thrive (four patients), degenerative central nervous system disease (one patient), and miscellaneous conditions (three patients). All procedures were performed under local anesthesia and sedation. An antegrade approach is described for percutaneous gastrostomy and percutaneous gastrojejunostomy placement. No major complication occurred, and only three skin infections have been encountered. The children were evaluated and followed up by a nutritional support team. Early experience with percutaneous gastrostomy and percutaneous gastrostomy and percutaneous gastrojejunostomy in the pediatric population suggests that the technique is safe and applicable to children of all ages and sizes. In particular, the antegrade approach appears to be an acceptable solution for enteric alimentation.