To better define the indications for and complications of rectal tube use in critically ill patients we prospectively studied every patient admitted to an intensive care unit over a 20-month period who required a rectal tube. Of these patients, 2.8% had rectal tubes inserted. Ninety- two percent were inserted to help decrease soiling from diarrhea and 6% were inserted to deliver medica tions. Tubes were in place an average of 3.3 days, and no complications were identified. Rectal tubes may be safely and effectively used to prevent soiling in critically ill patients with diarrhea. The use of rectal tubes as ad juncts to healing and preventing pressure sores in criti cally ill patients merits further study.