PURPOSE OF REVIEW: This review aims to provide a comprehensive overview of gastrointestinal dysmotility, particularly in critically ill patients within the ICU. It highlights the pathophysiology, prevalence, and clinical implications of conditions, such as oesophageal dysmotility, gastroparesis, ileus, and Ogilvie's syndrome. By examining current diagnostic and treatment approaches, the review emphasizes the importance of recognizing and managing gastrointestinal dysmotility to improve patient outcomes. RECENT FINDING: Recent literature indicates that up to 60% of ICU patients experience some form of gastrointestinal dysmotility, with those on mechanical ventilation being particularly at risk. The review identifies key contributors to gastrointestinal dysmotility, including inflammatory states, electrolyte imbalances, and the effects of certain medications. Nonpharmacological strategies, such as early enteral feeding, correcting electrolyte abnormalities, and mobilization are critical. Prokinetic agents have shown promise in alleviating feeding intolerance and improving gastric emptying, though their effects on overall mortality remain inconclusive. SUMMARY: Gastrointestinal dysmotility presents a significant challenge in critically ill patients, leading to various complications that hinder recovery. Understanding the underlying pathophysiology, coupled with effective diagnostic and treatment strategies, is essential for enhancing patient care. This review underscores the need for continued research and clinical focus on gastrointestinal motility disorders in the ICU to improve health outcomes for this vulnerable population.