Survival, functional outcome, care setting, early and late complications, and caregiver satisfaction were determined in 61 children with severe cerebral palsy requiring gastrostomies during a six-year period. Fifty-three (87%) of the initial gastrostomies included a Nissen fundoplication. Early and late complications were 32.8% and 39.3%, respectively. Survival after initial surgery was 84.2% at one year, and 67.6% at four years. One child died within one month of surgery. Seventy percent of the children remained totally dependent in self-care, mobility, and communication; an additional 29% had significant limitations in function. Only 4 children (6.5%) ultimately became independent in feeding. Ninety-three percent of the children were cared for at home. Ninety-four percent of the parents/caregivers believed the gastrostomy was beneficial in management of the child. Survival was unexpectedly high compared to studies of adults and mentally retarded children requiring similar surgical procedures.