Surgical and endoscopic techniques for creating access for enteral nutrition have been in existence longer and are currently more frequently utilized than the radiological forms of these procedures. In general, the fluoroscopic techniques are more easily performed and are better tolerated by the patient. A high degree of technical success can be achieved with all methods, however, radiological methods are generally associated with the lowest rates of major complications and the fewest procedural deaths. Each technique has unique advantages and disadvantages. Specific clinical situations are outlined in which a given technique may be advantageous. Overall, radiological enteral access procedures provide the most advantages and deserve more widespread utilization.