Objective: To analyze the application of percutaneous gastrostomy(PG) in patients with esophageal obstruction. Methods: The clinical data of patients undergoing gastrostomy for esophageal obstruction in our hospital from September 2016 to September 2019 were collected. Operative time, intraoperative blood loss, 2-day and 60-day postoperative pain test scores, beginning time of postoperative nutrition support, postoperative length of stay, 60-day morbidity, 60-day postoperative both body weight and serum albumin were compared between PG group and open gastrostomy (OG) group. Results: A total of 39 patients were studied including 12 cases with PG and 27 cases with OG. There was no signi-ficant difference in baseline data between two groups (P>0.05). The operative time and blood loss were (24.6±9.9) min and (8.8±3.0) mL in PG group respectively, which were significantly lower than those [(61.9±9.1) min and (26.0 ±7.8) mL] in OG group (P<0.001, P<0.001). The 2-day and 60-day postoperative pain scores were 1.60±0.50 and 0.75 ±0.50 in PG group respectively, lower significantly than those [(2.3±0.8) and (2.0 ±0.5)] in OG group (P=0.008, P<0.001). Beginning time of postoperative nutrition support [(18.8±4.6) h] and length of stay [(2.8±1.0) d] in PG group were significantly less than those [(64.3±15.7) h and (4.4±1.2) d] in OG group (P<0.001, P<0.001). Two cases lost follow-up in OG group. There was morbidity 8.3% (1/12) in PG group and 24.0% (6/25) in OG group respectively with no significant difference (P=0.389). The increase in 60-day postoperative body weight was (0.6±0.8) kg in PG group and (0.3 ±0.7) kg in OS group. There was significant difference of increase in 60-day postoperative serum albumin between PG group [(1.3±0.9) g/L] and OG group [(-0.1±1.3) g/L] (P<0.001). Conclusions: PG is minimally invasive and safe and effective with perioperative advantage when compared with OG and could be widely applied in patients with esophageal obstruction.