The gastrostomy button is a new, skin level, nonrefluxing, mushroom-tipped feeding device which can be used to replace conventional gastrostomy catheters. We have prospectively evaluated 31 consecutive patients managed with this appliance and our results show that the button can be successfully placed in 90% of cases without serious morbidity or mortality. The procedure is quick to perform, requires minimal intravenous sedation, and is well-suited to a broad range of socially active gastrostomy-dependent patients. Patients found the aesthetics, convenience, and independence of the low profile design attractive and no individual wished to return to the original method of feeding. Small and medium-sized buttons were easier to place than larger devices. Gastrocutaneous reflux through the appliance occurred in 11% of cases and was a common cause for replacement. Alert, ambulatory patients with an established gastrostomy and short or medium-sized gastrocutaneous fistulous tracts are ideal candidates for the button.