Intracranial penetration during attempted nasogastric intubation is a rare, usually lethal, but avoidable complication. Such incidents are associated with facial and basilar skull fractures, acute neurologic deterioration, and litigation. We report two such incidents and the successful surgical procedure which utilized craniotomies positioned such that the nasogastric tubing could be removed in small, straight segments. The tubing in each case was removed without increasing the neurologic deficit, and the patients made an acceptable recovery considering their premorbid status.