Objective: To study the safety and efficacy of percutaneous fluoroscopic gastrostomy tube placement in patients with head and neck cancer. Design: We conducted a retrospective case review of 92 consecutive cases. Comparable access procedures and relevant literature were reviewed. Setting: Academic tertiary care center. Patients: Patients with head and neck cancer who underwent percutaneous fluoroscopic gastrostomy tube placement between January 1996 and July 1996. Main Outcome Measures: Immediate, delayed, and long-term complications; tube malfunction; and tube placement failure. Results: The major complication rate was 1%; the minor complication rate was 8%; and the tube malfunction rate was 13%. The rate of successful tube placement was 98%. None of the patients required hospitalization as a result of the procedure. Conclusions: Percutaneous fluoroscopic gastrostomy tube placement is a safe, economical, and comfortable method that has distinct advantages over other gastrostomy tube placement methods. It is recommended for enteral feeding and nutritional supplementation in patients with head and neck cancer.