Early enteral nutrition (EN) provides many benefits including attenuating stress hormones and the hypermetabolic response, decreasing gut permeability, and reducing the energy and protein deficit. Timing of EN is crucial as studies have shown that delaying initiation of EN leads to intolerance of enteral feeding. Burn size has also been correlated with timing and intolerance of EN with larger burns having delayed feeding times and more gastric intolerance. The aim of this study is three-fold: to determine if there is an association between 1) burn size and gastric intolerance; 2) inhalation injury and gastric intolerance; 3) delayed initiation of enteral feeding and gastric intolerance. A retrospective study was conducted on one hundred twenty eight patients admitted to our burn center who required EN from August 2013 to June 2018. Gastric intolerance was defined by four factors: emesis, gastric residual volume >500ml, distention, and the therapeutic use of prokinetic agents. Delayed enteral feeding was defined as ≥12 hours post-admission to the hospital. Patients were grouped by presence of inhalation injury and percentage of total body surface area (<20% and ≥20% TBSA). Using SPSS, Chi Square and multiple regression analyses were performed. The average burn size was 30%. Mean time to start EN was 16.8 hours and patients had an average of 3.2 episodes of intolerance throughout their hospitalization. %TBSA and the presence of an inhalation injury were associated with intolerance. Patients with ≥20%TBSA had one or more signs of gastric intolerance (p = 0.003). Presence of an inhalation injury was associated with two or more episodes of gastric intolerance (p = 0.043). Delayed initiation of EN was also associated with two or more episodes of gastric intolerance (p = 0.017). Adequate nutrition is vital for the burn patient. Larger burn size (≥20%TBSA) and inhalation injury are associated with greater gastric intolerance. Early EN (<12hrs post-admit) is associated with less gastric intolerance which allows patients to receive a greater percentage of their necessary nutrition for healing. In patients with a burn size ≥20%TBSA and/or the presence of an inhalation injury, post-pyloric access could be considered along with early initiation of EN to reduce gastric intolerance and failure to meet the patient’s nutrition goals. <!--EndFragment-->