The study and practice of nutrition support has been evolving for centuries. The last 50 years has brought this practice in nutrition therapy to a very important place in medicine. As treatments have become more sophisticated in fighting disease and saving lives, the role nutrition support has become recognized as vital to patient care. The most current evidence based practice in the field is implemented to provide the best nutrition care to those in need. Selecting patients whom benefit from nutrition intervention is an important responsibility of the healthcare team, which includes identification of malnutrition. This area of practice demands an understanding of indications for the route of nutrition support, knowledge of access devices, and components of ordering and monitoring nutrition support regimes. Enteral nutrition has become the most utilized form of nutrition support, while parenteral nutrition remains a life sustaining measure for those with loss of gastrointestinal function. The variety of enteral formulas available is vast, and understanding indications and use is an ongoing challenge. Several ethical issues surrounding nutrition support, with end of life situations being a common dilemma. Application of evidence based practice in certain disease states and conditions demands literature review, collaboration, and implementation of identified best practices.