Summary Background & aims Maintaining nutritional intake after oesophago-gastric resection is challenging, particularly on a background of malignancy. Failure to thrive after surgery is detrimental to health related quality of life (HRQL). Minimally invasive surgery is less traumatic and allows faster recovery and restoration of HRQL. This study examines the nutritional consequences for patients undergoing this approach to definitive cancer treatment. Methods Data was recorded prospectively on 124 consecutive patients undergoing minimally invasive oesophago-gastric resection (MIOGR) between July 2004 and July 2009. Nutritional status was quantified using body mass index (BMI) recorded pre-operatively and approximately 6 weeks, 6 months and one year after surgery. Results The median pre-operative BMI was 25.8 with 62% patients overweight. Median BMI loss was 5.0% at the first follow-up, 7.8% at the second and 7.0% at the third. Although 53% of patients had lost over 10% of their pre-operative BMI at one year, 52% patients still had a normal BMI and 34% remained overweight. Conclusion The decline in nutritional status after MIOGR is less profound than observations from open surgery. The limited trauma of this approach and subtle differences in reconstruction of oesophago-gastric anatomy might impart nutritional advantages for patients.