Following local anesthesia to the nose, through-the-nose (TTN) passage of a paediatric gastroscope was successful and well tolerated in 82 of 92 patients on whom it was attempted in order to place nasogastric feeding tubes. This technique allows for guidewire placement to be used for insertion tubes or dilators. The ten failures we observed occurred in patients with bilateral narrow turbinates. We conclude that the TTN approach is quicker and easier than conventional methods of feeding tube placement allowing for an additional endoscopic evaluation of the upper GI tract.