Gastrostomy was carried out in lieu of gavage feeding on each of 11 premature infants whose birth weights ranged from 454 to 1249 gm (1 lb to 2 lb 12 oz). None of the 4 deaths were related to the gastrostomy per se or the effect of the procedure on the infant. In the 7 remaining patients feeding was successful, and, to date, their development has been satisfactory. It is recommended that the simple and safe method of gastrostomy feeding be considered for the small or frail premature who will require prolonged mechanical aid to feeding.