Sucralfate is a common medication used to treat duodenal ulcers, gastric ulcers, and gastritis. The off-label use of topical sucralfate has been described in the literature to induce wound healing in epithelial injury. Yet, current literature lacks clinical depictions in the application of sucralfate to treat a common gastrostomy tube complication, that of a dilated gastrostomy site. We present a case report of a medically complex pediatric patient where topical sucralfate was applied to reduce the size of a large gastrostomy stomal defect. Sucralfate was used to reduce healing time and allow introduction of a new gastrostomy device through the same stomal opening without the need for additional procedures or surgeries.