Nasogastric intubation is a frequent practice in clinical care used for administering enteral feed, gastric decompression, and lavage. The knotting of a nasogastric tube is a rare complication with only a few incidences of narrow bore nasogastric tube knotting and even fewer wide-bore tubes reported [1-4]. Unrecognized knotting of the nasogastric tube with inadvertent removal may cause catastrophic consequences like epistaxis, respiratory distress’ severe laryngeal injury, and tracheoesophageal fistula [5-7]. Tubes have been found to be kinked and less commonly knotted. Cases of knotting have previously been identified during insertion or blockage of the tubes post-insertion. Ours is a case of nasogastric tube knotting identified in a young patient with a working tube that knotted over itself during removal.