BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a commonly-performed procedure for patients with swallowing disabilities. Though safe and technically simple, PEG is often associated with some complications, and occasionally requires tube replacement. The aims of this study were to evaluate the complications and the proper indication of PEG by analyzing the success rate and tube replacement. METHODS: We reviewed medical records of 81 patients who underwent initial PEG and 92 patients who underwent tube replacement or removal from January 1995 to December 2003. RESULTS: Underlying diseases included cerebrovascular accident (51%), spinal cord injury (12%), hypoxic brain damage (11%), and head trauma (11%). PEG success rate was 93%. Twenty five patients (31%) showed various complications. Wound infection was the most common (10/25, 40%) complication, and most complications (64%) occurred within 10 days, but 24% of complications occurred 1 month after the procedure. Mean duration for tube placement was 7.3 months. The reasons for tube replacement or removal were worn-out (36 cases, 39%), unwanted self extraction (14 cases, 15%), and death (11 cases, 12%). CONCLUSIONS: PEG is a safe and effective method for enteral nutrition. However PEG shows some complications, and occasionally needs tube replacement. It is crucial to select the appropriate patient and to perform careful procedure.