Pediatric patients with gastrostomy or intestinal ostomy continue to be a challenge to pediatric primary health care providers. In caring for these patients, the physician's role is vital in providing quality care with appropriate intervention, prevention, and management for potential complications, patient and family education, and provisions for services and supplies. Often, acquired conditions or congenital anomalies are stressful, and families require assistance with coping and encouragement to master new skills. This article presents a brief overview of gastrostomies and intestinal ostomies, including care and management of various devices and appliances, and troubleshooting commonly encountered problems.