Background & aims: Postpyloric feeding is frequently indicated in clinical practice. Postpyloric enteral tube placement can be cumbersome, necessitating use of fluoroscopy and/or endoscopy. Guiding devices have been developed to facilitate bedside tube placement. We aimed to evaluate the feasibility and safety of postpyloric enteral tube placement in children using an electromagnetic-guided system as a rescue strategy in case blind tube insertion failed. Method: In a prospective pilot study in 10 children postpyloric enteral tube placement using an electromagnetic-guided placement was attempted after blind placement failure. Results: Postpyloric enteral tube placement was successful in 6 of the 10 included patients. No adverse events occurred and it was well tolerated. Conclusion: This pilot study suggests that electromagnetic-guided placement as a rescue technique for postpyloric enteral tube placement can prevent the use of fluoroscopy and/or endoscopic placement in a substantial portion of patients.