Although, Enteral Nutrition (EN) is a long established practice in critical care but, the ideal prescription and administration still represent a challenge. Patients admitted to intensive care unit, always receive less EN than the prescribed volume, leading to increase the risk of malnutrition, and contributing to negative hospital outcomes. Also contamination of the enteral formulations is very common and might lead to the occurrence of nosocomial infections in the form of diarrhea, bacteremia and pneumonia. EN delivery is available in two main systems: An Open System (OS) or Closed System (CS) which sometimes called a «Ready to Hang» system (RTH). Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered (open or closed) is very limited. This review highlights current practice and areas of concern and establishes our current knowledge in this field.