Artificial support of both ventilation and nutrition is mandatory in advanced stages of neuromuscular diseases. Radiologically inserted gastrostomy is performed during an interventional radiological session by a trained interventional radiologist, under fluoroscopic guidance with deep sedation managed by an anaesthesiologist. In the case of procedures in patients with amyotrophic lateral sclerosis or in advanced stages of degenerative neuromuscular diseases, non-invasive ventilation is increasingly considered during the periprocedural period of gastrostomy, making deep sedation and appropriately setting ventilatory parameters pivotal for a successful procedure. Preprocedural training of the patient to ensure optimal adaptation to non-invasive ventilation and to mechanical in-exsufflation is mandatory for a successful periprocedural course.