BACKGROUND: The traditional practice after gastrointestinal anastomosis is to fast patients until return of bowel sound and passage of flatus based on the assumption that the risk of vomiting from postoperative ileus and anastomotic disruption will be reduced. Recently, great emphasis has been placed on early oral feeding resumption within 24hours of surgery. AIMS AND OBJECTIVES: To compare the outcome (time taken to pass flatus and stool, time for return of bowel sounds, anastomotic leak, surgical site infection, aspiration pneumonitis/ pneumonia, tolerance and length of postoperative hospital stay) of early oral feeding and traditional delayed feeding resumption after gastrointestinal anastomosis. PATIENTS AND METHODS: A prospective randomized control study carried out between March 2016 and March 2017. Patients that satisfied the inclusion criteria were randomized into a study group (early oral feeding) and control (traditional) group, with an allocation ratio of 1:1 using online computer generated random numbers. The study group was commenced on early oral feeding 24 hours postoperatively while the control group was managed using the traditional regime. The patients were followed up postoperatively for 6 weeks and outcome measures evaluated. Analysis was done using SPSS Version 20 software. RESULTS: Sixty patients were randomized into a study and control group with 30 patients in each arm. Time taken to pass flatus was 42.6±22.0hrs in the study group and 70.3±23.3hrs in the control group (p=0.000). The study group passed stool earlier (69.8±37.0hrs) than the control group (89.5±29.2hrs) p=0.026. Bowel sounds returned 31.4±13.3hrs postoperatively in the study group and 53.8±21.7hrs in the control group (p=0.000). Eight (27.6%) patients in the study group had surgical site infection compared to 17(56.7%) in the control group (p=0.024). No patient in the study group had anastomotic leak while 1(3.3%) leaked in the control group (p=1.000). Twenty six (86.7%) patients tolerated early oral feeds in the study group. The length of postoperative hospital stay was 9.6±4.8 days in the study group and 13.9±7.9 days in the control group (p= 0.021). CONCLUSION: Early oral feeding after gastrointestinal anastomosis led to an earlier passage of flatus and stool and a faster return of bowel sounds. It also reduced the rate of surgical site infection and reduced the length of postoperative hospital stay. It had no effect on the rate of anastomotic leak or aspiration pneumonitis/pneumonia. KEY WORDS: Early oral feedinG