This UK national survey set out to find the most commonly used gastrostomy insertion technique and to estimate the number of cases of gastrostomy site tumour seeding experienced over the last 3 years. Questionnaires were sent to one maxillofacial consultant of 154 UK hospitals, details of whom were obtained using the directory of the British Association of Oral and Maxillofacial Surgeons. Questionnaires were returned from 65% (100/154) of hospitals. Overall 61% of maxillofacial surgeons stated that gastrostomies were inserted in their hospital for head and neck (H&N) cancer patients. Percutaneous endoscopic gastrostomies (PEGs) were the routine choice for insertion of gastrostomy in 82% of hospitals, and a small number of hospitals used PEG and radiologically inserted gastrostomy (RIG). Pull through was the predominant technique used for PEG replacement in 77% of hospitals. Only 5% (3/58) hospitals had seen any cases of gastrostomy site tumour seeding in the last 3 years. The incidence of seeding was estimated as 3 per 5000 cases requiring gastrostomy insertion. Most units still use the pull through technique of PEG insertion in spite of guidelines from the British Society of Gastroenterologists advocating push insertion. Gastrostomy site seeding was estimated to have occurred in only 5% of units over a 3 year period.