Background:The use of gastrostomies in children is increasing and their need for long-term management following insertion presents a potentially significant financial and resource challenge to local healthcare systems.Objectives:The aim of this study was to determine the yearly cost of maintaining a gastrostomy in a pediatric patient.Methods:A retrospective, bottom-up cost-analysis was conducted in a cohort of 180 patients with gastrostomies aged 0–19 years. One in 5 patients were randomly selected for individual cost analysis (n = 36). Their electronic health record was interrogated from the period of March 1, 2019–March 1, 2020. Costs included in the analysis were staff contact time from the community nursing and nutrition teams, and equipment costs.Results:The mean cost of maintaining a pediatric gastrostomy across all ages was £709.87 (SD 403.18) per year. Mean annual cost varied by age, underlying diagnosis, and gastrostomy device, but this variation was only statistically significant for the type of device, with Mic-Key buttons having a mean annual cost of £834.66 (SD 307.85), Mini buttons £799.06 (SD 395.01), and percutaneous endoscopic gastrostomy tubes £279.34 (SD 297.45;P= 0.004).Conclusion:The mean cost of maintaining a gastrostomy in a pediatric patient is just over £700 per year. The cost is the highest as a child enters adulthood. Button devices have higher maintenance costs compared with percutaneous endoscopic gastrostomy tubes.