Gastrostomy tube placement is a common procedure in the inpatient setting due to the increasing burden of critical illness. Minimally invasive percutaneous approaches, such as endoscopic and radiologic placement, are preferred over surgical placement of gastrostomy tubes in eligible patients. The optimal percutaneous approach remains to be determined. Surgeons, gastroenterologists, and interventional radiologists have a long history of gastrostomy placement. Due to a facility with bronchoscopy and minimally invasive procedures, interventional pulmonologists can perform this procedure with high rates of success and minimal complications. Refined methods, such as percutaneous ultrasound gastrostomy, have allowed for performance at the bedside in the intensive care unit and facilitated integration into tracheostomy and gastrostomy teams with patient and health system benefits.