['Endoscopic enteral stenting (ES) in malignant gastric outlet obstruction (GOO) is limited by high rates of stent obstruction. EUS-guided gastroenterostomy (EUS-GE) is a novel procedure that potentially offers sustained patency without tumor ingrowth/overgrowth. The aim of this study is to compare EUS-GE with ES in terms of (1) symptom recurrence and need for re-intervention, (2) technical success (proper stent positioning as determined via endoscopy and fluoroscopy), (3) clinical success (ability to tolerate oral intake without vomiting), and (4) procedure-related adverse events (AEs).', 'Multicenter retrospective study of all consecutive patients who underwent either EUS-GE at four centers between 2013 and 2015 or ES at one center between 2008 and 2010.', 'A total of 82 patients (mean age 66-years\xa0±\xa013.5 and 40.2% female) were identified: 30 in EUS-GE and 52 in ES. Technical and clinical success was not significantly different: 86.7% EUS-GE versus 94.2% ES (p\xa0=\xa00.2) and 83.3% EUS-GE versus 67.3% ES (p\xa0=\xa00.12), respectively. Symptom recurrence and need for re-intervention, however, was significantly lower in the EUS-GE group (4.0 vs. 28.6%, (p\xa0=\xa00.015). Post-procedure mean length of hospitalization was comparable at 11.3\xa0days\xa0±\xa06.6 for EUS-GE versus 9.5\xa0days\xa0±\xa08.3 for ES (p\xa0=\xa00.3). Rates and severity of AEs (as per the ASGE lexicon) were also similar (16.7 vs. 11.5%, p\xa0=\xa00.5). On multivariable analysis, ES was independently associated with need for re-intervention (OR 12.8, p\xa0=\xa00.027).'] Is eUS-guided gastroenterostomy comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction?