We undertook a retrospective review of 25 patients who had undergone percutaneous endoscopic gastrostomy (PEG). Data regarding the clinical courses were collected, and a questionnaire was administered to patients when possible; in most cases the individual responsible for care answered questions. We pinpointed concerns relevant to the decision-making process. In a substantial proportion of cases, the clinical courses subsequent to PEG were poor. Of 21 surrogates interviewed, 33% were uncertain that proceeding to nutritional support via PEG had been the right decision. Findings indicate a need to improve the process by which decisions to treat by PEG are made, ideally including better prognostic information.