OBJECTIVE To review our series of percutaneous endoscopic gastrostomy (PEG) tube placement by the Division of Otolaryngology. METHODS Charts from a total of 29 patients were reviewed; 23 patients with head and neck cancer and six patients with chronic aspiration. METHODS Placement of a PEG tube and other associated procedures, including primary tumor resection, tracheostomy, and surgical endoscopy. METHODS The feasibility, morbidity, and mortality of PEGs performed at the time of the primary surgical procedure compared with those being performed with a minor procedure. RESULTS In almost all cases, the PEG was performed in conjunction with another procedure requiring general anesthesia, thereby decreasing the total number of procedure days. Morbidity and mortality were absent for all patients in whom PEG was performed. CONCLUSIONS When properly applied, PEG can be performed by the otolaryngologist-head and neck surgeon with minimal or no morbidity at the time of staging or definitive procedure. Thus, the PEG can be of great benefit in patients with head and neck cancer.