Objective To study the effect of early minimal feeding on neonatal gastrointestinal motility. Methods Thirteen critically ill neonates who needed mechanical ventilation were enrolled in this study between September, 1998 and February, 1999. The infants were devided into two groups, one of which received early minimal enteral feeding while the other received all fluid requirements via total parenteral nutrition (controls). The minimal feeding group started enteral feeding (2 ml·kg -1 ·2h -1 ) at 2.5 days after birth, and the control group at 13.6 days postnatally. Results Minimal feeding promoted gastric emptying [( 32.6 ± 12.2 )% vs. (16± 5.5 )%] and shortened the time to establish complete enteral nutrition [( 17.5 ± 8.0 ) vs. ( 34.9 ± 17.7 ) days, P< 0.05 ] and the time to establish complete oral nutrition [( 12.2 ± 8.3 ) vs. (31± 11.2 ) days, P< 0.05 ]. There was no significant difference noted in the amount of gastrointestinal reflux, serum levels of gastrin and motilin, days to regain birth weight, and length of hospitalization between the two groups. Conclusions Early minimal enteral feeding could improve the neonatal gastrointestinal motility and reduce the occurrence of feeding problems in critically ill neonates.