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Purpose: This study evaluates respiratory complications related to nasogastric feeding tube insertion in intensive care units (ICU). Methods: This was a retrospective, observational study undertaken in adult intensive care units between August 1, 2014 and October 31, 2014. Critically ill patients who had small-bore feeding tubes for enteral feeding inserted in ICUs comprised the study sample. Information collected by medical record review included demographics, clinical characteristics, and data related to the feeding tube insertion (mechanical ventilator, artificial airway, Glasgow Coma scale, confusion assessment method for the ICU, sedative drug use, postplacement X-ray, and complications). Results: Two hundred and seventy-six patients were included in the study sample. The median age was 64, and male patients were 67% of the sample. One hundred and eighty-nine patients (69%) were treated with a mechanical ventilator and 215 patients (78%) needed an endotracheal tube or tracheal cannula during feeding tube insertion. Twelve feeding tubes (4%) were inserted into patients' tracheobronchial trees and four pneumothoraxes (1.4%) were checked by postplacement X-ray. Conclusion: Respiratory complications associated with feeding tube insertion are not rare. Such complications can lead to significant morbidity and mortality. Practitioners should be cognizant of the potential risks of feeding tube insertion. Standard protocol should be considered to minimize the risk.