Several types of gastrostomy tube are available. The gastrostomy button (GB) is a skin-level device that is easily used and acceptable to ambulatory patients. Previously, GB required the presence of a mature gastrocutaneous tract, necessitating a two-stage procedure for placement. We report our experience with one-stage GB placed in 24 patients. No difficulties with placement and no periprocedural complications occurred. GBs remained in place from 14 to 148 days (mean 71 days). Thirteen GBs were in place at follow-up. Four patients died from primary disease. Seven GBs were no longer needed, and were removed. No stomal infections occurred; no GBs were inadvertently removed; all GBs were convenient to use. Four complications occurred (17%): two tubes clogged, one colocutaneous fistula developed, and one tube migrated from the stomach into the abdominal wall. Complications were corrected without sequelae. One-stage GB is safe and feasible with comparable complication rates to standard PEG.