Gastrointestinal (GI) surgery in children with seizure disorders is often complicated by difficulties in administering oral anticonvulsant medications in the preoperative and postoperative periods. Because many newer anticonvulsants do not have parenteral formulations, intravenous phenobarbital, phenytoin, and benzodiazepines may appear necessary in the perioperative period. Eight children with neurologic disease with severe seizure disorders underwent gastrostomy placement and Nissen fundoplication. Perioperatively, their anticonvulsants were given successfully via the rectum. Rectal administration of anticonvulsants is a useful alternative route for drug therapy in seizure patients who are undergoing GI surgery.