Aim: This systematic review analysed morbidity and mortality related to the type of technique used to insert gastrojejunal feeding devices in children.Materials and methods: The Healthcare Database Advanced Search, Cochrane and Medline databases were used. PRISMA guidelines were followed by two independent reviewers. Non-English language, mixed report of more of one technique and adult population studies were excluded.Results: Twenty-three papers were selected; overall, 648 patients underwent jejunal tube insertion: 287 received percutaneous gastrojejunal tube (PEG-J), 140 underwent Laparoscopic-Assisted Jejunostomy (LAJ) and 221 received an open surgical jejunostomy (OSJ). Main indications for jejunal feeds were: neurological impairment (NI), inability in establishing gastric feeds, recurrent aspiration pneumonia, severe Gastroesophageal Reflux Disease, and failed fundoplication. 71.5% of patients experienced minor tube-related complications (misplacement, dislodgment, coiling, and breakage). Major complications were volvulus, bowel obstruction and intussusception accounting, respectively, for 7.2% amongst the PEG-J population, 7.6% amongst the LAJ and 10.7% in between the OSJ population. Mortality related to PEG-J placement was 9.3%, in comparison to the LAJ accounting for 14.6% and 7.8% amongst the OSJ group.Conclusion: Mortality and morbidity rate following gastrojejunal feeding tube insertion remains high despite the type of surgical technique used. Careful patient selection, accurate family counselling and multidisciplinary evaluation at decision-making time, is pivotal when considering this enteral feeding route. A clear standardised pathway, also establishing a patient’s inclusion criteria for a more radical approach (such as the Total Esophagogastric Disconnection), should be implemented to improve patient’s quality of life and career’s quality of assistance.