Intragastric balloon techniques were used to achieve direct gastric distention and efferent loop obstruction in order to perform percutaneous gastrostomy on two occasions in a patient with a partial gastrectomy and Billroth II anastomosis. Previous attempts at percutaneous endoscopic gastrostomy and conventional radiologic percutaneous gastrostomy had been unsuccessful. Although a history of partial gastrectomy has been considered an impediment to both percutaneous gastrostomy and percutaneous endoscopic gastrostomy, this experience demonstrates that percutaneous gastrostomy can be performed safely in this setting with balloon assistance.