To present a case of Percutaneous Endoscopic Jejunostomy in traumatic brain injured patient with subtotal gastrectomy. A 54-year-old man who injured a left subdural and intraventricular hemorrage by a falling. The patient had a history of the subtotal gastrectomy and suffered significant gastroesophageal reflux and recurrent aspiration pneumonia during nasogastric tubal feeding. The traditional Percutaneous Endoscopic Gastrostomy was inappropriate procedure for him because of significant alteration of gastric anatomy, insufficient volume of remnant stomach, and continuous gastroesophageal reflux. Direct percutaneous endoscopic placement of a jejunostomy tube was performed and we provide adequate enteral nutritional support in a traumatic brain injured patient with subtotal gastrectomy and gastroesophageal reflux.