In the current economic climate increasing numbers of hospitals are outsourcing arrangements for food preparation and service. There is debate among health professionals about the most appropriate role, if any, of nurses in feeding patients. This paper reports on a comprehensive review of the literature over the last 30 years pertaining to patient nutrition and food service in hospital. It is apparent that many patients are admitted in a malnourished state and that deterioration of nutritional status frequently occurs during hospitalization. At the same time there is evidence that appropriate and prompt attention to patient nutrition by nurses and other health professionals has a positive influence on patient outcome and hospital costs. The implications for nursing are discussed.