It is now widely recognized that the frequency of complications after major surgery is influenced by the nutritional status of patients prior to surgery and the maintenance of nutrition after the surgical procedure. Early refeeding after many surgical procedures is not only safe but is associated with fewer complications and shorter hospital stays. For most patients, even those who are critically ill, enteral feeding is preferred over parenteral nutrition because of fewer infectious complications, fewer anastomotic leaks after bowel resection and, in some studies, a lower mortality. For patients who are unable to swallow, enteral feeds can be given by nasogastric or nasoenteric tubes or, for longer-term feeding, percutaneous gastrostomy or enterostomy. Indications for parenteral nutrition include intestinal obstruction, uncontrolled peritonitis, ischaemic gut, short bowel syndrome and high output fistulas. Long-term parenteral nutrition requires a dedicated nutritional team that is able to monitor access lines, nutritional requirements and infectious and metabolic complications.