A review of 100 personal cases of open gastrostomy using a modified Stamm technique showed that the majority (82.7%) could be performed using local anesthesia with intravenous sedation. Only one patient suffered a wound infection, and there were no other technical complications. The use of a separate stab wound for the introduction of the tube and the routine use of antibiotic irrigation might have contributed to the reduction of wound complications. The overall mortality was 18 per cent, and all of the deaths were due to the patients underlying diseases. The Stamm procedure, which can be performed under local anesthesia without undue discomfort in the majority of patients, has a very low morbidity and no intrinsic mortality. It has a proper place in the armamentarium of nutritional support for these terminally ill patients.