To evaluate the clinical benefit of prokinetic therapy in aspiration pneumonia in patients with developmental disabilities, we conducted a retrospective study; records of 22 tube-fed patients were reviewed from December 1990 to October 1998 for a mean of 22.7 months before and 38.9 months during Cisapride therapy. Numbers of hospital admissions per patient-year before and during Cisapride administration were reduced from 2.75 to .61, with a relative risk reduction of 4.5. Days of hospitalization were reduced from 32.3 to 6.4. There were no adverse events noted from the therapy. Appropriately monitored prokinetic therapy may prove to be beneficial in preventing aspiration pneumonia in selected patients with developmental disabilities.