A modified Gauderer-Ponsky technique of percutaneous endoscopic gastrostomy has been described. The major advantage is elimination of a second insertion of the endoscope, as well as unnecessary traversing of the esophagus by snares and strings. The result achieved is equal to what has been achieved with the original technique, but the single-pass technique is more expeditious and less uncomfortable for the patient. In addition, it can easily be modified to insert both draining gastrostomy and feeding jejunostomy tubes at the same time, using only one pass of the endoscope.