Background: Feeding intolerance is extremely common in premature neonates. Cessation or delays in enteral feeding may result in poor neurodevelopmental and growth outcomes in preterm infants. So proper developmentally supportive post feeding positions is considered one of the key measures that are carried out by neonatal nurses. Aim: determine the effect of developmentally supportive post feeding positions on gastrointestinal feeding tolerance among preterm neonates. Design: A cross-over experimental research design was used to accomplish this study. Setting: The study was conducted at the Neonatal Intensive Care Unit at El-Shatby Maternity University Hospital in Alexandria. Subjects: A purposive sample of 30 preterm neonates comprised the study subjects. Tools: Three tools were used to collect the data: Tool I: Preterm neonates' characteristics and clinical data assessment sheet. Tool II: Feeding pattern of preterm neonates assessment sheet. Tool III: Preterm neonates' gastrointestinal post feeding tolerance assessment sheet. Results: The majority of preterm neonates (96.7% and 96.3% respectively) had no gastric residual after positioning on developmentally supportive semi recumbent position after feeding either after 69 or 120 minuts. There were statistically significant differences between the developmentally supportive post feeding positions. Moreover, there were statistically significant differences found between developmentally supportive post feeding positions at 60 minutes after feeding regarding abdominal distention, vomiting and regurgitation. Conclusion: The results of this study concluded that placing preterm neonates on developmentally supportive right lateral, left lateral and semi recumbent post feeding positions reduce gastric residual volume and improve signs of gastrointestinal feeding tolerance. Recommendations: Continuous training in neonatal intensive care units for nurses should be performed for caring and placing preterm neonate in developmentally supportive right lateral, left lateral and semi recumbent post feeding positions.