Enteral nutrition therapy can improve outcomes in many disease states such as pancreatitis and inflammatory bowel disease, and in critically ill patients. Obtaining enteral access is fundamental in order to provide enteral nutrition. The endoscopist plays an important role in placing enteral access systems. The endoscopist should be familiar with the techniques to perform percutaneous endoscopic gastrojejunostomy (PEG/J), direct percutaneous jejunostomy (DPEJ) and bedside nasoenteric tube placement as well as the management of complications that can result from their placement.