Percutaneous endoscopic gastrostomy (PEG) tube placement has revolutionized long-term enteral access in a wide variety of patients. This study assesses the overall PEG post-procedural complication rate as well as compares effects on the complication rate of steroid treatment, antiplatelet or deep venous thromboembolus (DVT) prophylaxis, prior abdominal surgery, or pre-procedural antibiotic therapy.A retrospective review was conducted for all patients who underwent PEG placement at a single institution between January 2002 and September 2006. Complication rates for patients on steroids, on antiplatelets/DVT prophylaxis, with prior abdominal surgery and on preprocedural antibiotics were compared by chi square analysis to those who did not receive these treatments. Complications were defined as bleeding, wound infection, buried bumper, tube dislodgement, abdominal complaints, inability to tolerate gastric feeding, hypoxia and hypovolemia. 589 patients underwent successful PEG placement The mean patient age was 62 years (range 18-97 years) and 63% were male. 55 patients (9.3 %) were receiving steroid therapy. 220 patients (37 %) were receiving DVT prophylaxis or antiplatelet therapy. 206 patients (35 %) had a history of previous abdominal surgery. 224 patients (38 %) received preprocedural antibiotics. The overall complication rate was 10 %: bleeding (1.2 %), tube dislodgement (1.2 %), wound infection (2 %), buried bumper (0.6 %), abdominal complaints (5 %), inability to tolerate gastric feeding (1 %), hypovolemia and hypoxia (0.3 %). There were five deaths (0.85 %). The complication rates for the steroid group and the steroid free group were 17 % and 10 %, respectively (NS). The complication rate for the antiplatelet/DVT prophylaxis group was 17.6 % versus 7.6 % for those not on therapy (NS). The complication rate for prior surgery was 11.3 % versus 11 % for those without prior surgery (NS). The wound infection rate for patients receiving preprocedural antibiotics was 0.9 % versus 2.8 % for those not on treatment (NS). There was no significant difference in complication rates of patients with prior abdominal surgery, receiving steroid therapy, receiving antiplatelet therapy or DVT prophylaxis, or receiving preprocedural antibiotics.Questions often arise regarding increased risk of complication in patients receiving steroid treatment or antiplatelet/DVT prophylaxis treatment. Our results do not show increased complication rates in these patients. For patients receiving steroid treatment, receiving antiplatelet/DVT prophylaxis, or with prior abdominal surgery, percutaneous gastrostomy tube placement should be considered safe.