Nasogastric tube insertion is a common medical procedure, with approximately 1.2 million performed annually in the United States [1]. However, complications can sometimes be fatal [2]. Herein, we report the case of an 82-year-old woman with a putaminal hemorrhage who required nasogastric tube insertion due to impaired consciousness. A feeding tube (Kangaroo, Cardinal Health) was initially inserted through the right nostril but encountered resistance at a depth of 10 cm. After reinsertion, the tube advanced smoothly to 50 cm. During auscultation, the stylet was found to be protruding approximately 10 cm beyond the proximal end of the tube and was reinserted. Chest radiography revealed that the stylet had punctured the tube 10 cm from its distal tip (Fig. 1). Both the tube and the stylet were subsequently removed, revealing stylet-induced damage but no structural defects (Fig. 2). The patient did not experience any adverse events. Although rare, feeding tube damage during insertion underscores the risk associated with stylet reinsertion, and this practice should be avoided to prevent potential complications. Written informed consent was obtained from the patient for the publication of the clinical information and related images.