We evaluated the effectiveness of a percutaneous technique for placement of a drainage gastrostomy. Progressive dilatation of the abdominal and gastric walls was used to place a Malecot catheter (28 French). Endoscopic guidance assured proper placement and assisted in the dilatation. Fourteen drainage gastrostomy tubes were placed in 12 patients. The tube could not be placed in on additional patient with tumor infiltration into the anterior gastric wall. No surgical complications occurred, but there was one postoperative complication, peritonitis treated with antibiotics without catheter removal. All catheters provided unobstructed drainage and decompression of gastrointestinal obstruction. Percutaneous endoscopic drainage gastrostomy seems to be an effective means of palliating small-bowel obstruction and its complication rate appears low. This method may be suitable to replace open laparotomy techniques for gasrostomy placement.