Nutritional management is a type of basic therapy common to the treatment of all diseases. Appropriate nutritional management in response to the needs of individual patients is called nutrition support, and an interdisciplinary group performing this function is called a nutrition support team (NST). The NST concept began with the development of total parenteral nutrition in 1968, although it did not immediately spread to Japan. In 1998, the potluck party method, a uniquely Japanese administrative system, was proposed, and NSTs were established in facilities throughout the country. In 2001, the Japanese Society for Parenteral and Enteral Nutrition planned the NST Project to support the establishment of NSTs under societal guidance. From 2006, the basic activities of NSTs in hospitals have been covered by healthcare fees. By 2010, the full range of activity of NSTs had been recognized as a necessary medical service in Japan with its aging population, and total medical fees for NST activities were covered by the social insurance system. By the end of 2014, NSTs had been established in more than 1,480 facilities nationwide. NSTs are now recognized as one of the most important medical tools available, including their social nutrition activities. Therefore, NSTs are expected to have increasing therapeutic usefulness in Japanese society with its growing proportion of elderly residents.