Percutaneous gastrostomy tubes (G-tubes) are used to decompress symptomatic patients with inoperable malignant bowel obstruction. Complications of G-tubes have rarely been reported in the palliative care literature. Nonetheless, complications are not uncommon and could interfere with the quality of life of patients, as illustrated by our case report. Given the increased use of percutaneous G-tubes, more attention needs to be paid to the prevention, early detection, and treatment of potential adverse events. Patients and their caregivers must receive appropriate education about complications of G-tubes and be made aware of the early signs and symptoms that must be brought to the attention of health care providers. Management of complications requires the use of health care resources that often can be found only in an acute care setting, and often requires referral to an interventional radiologist or endoscopist. Routine referral for G-tube placement before medical management has been maximized may not minimize suffering in patients with life-limiting illnesses.