Access for long-term enteral nutrition has long been the job of the surgeon. While percutaneous endoscopic gastrostomy has revolutionized the way we provide gastric feedings, jejunal access usually requires laparotomy. We have developed a technique for placing a laparoscopic guided jejunostomy. Twenty-three patients have undergone this procedure without complication. We believe this technique will be a valuable addition to the surgeon's options for obtaining enteral access.