A nasogastric tube insertion system (100) comprises a nasogastric tube (110),a guide element (120), and an inserter element (130). The inserter element hasa slim, elongate main body'i a handle attached to the body, and an anatomicallcurved insertion section. The guide element comprises a swallowable weightattached to a cord, string, monofilament line, tube, or other similar line. Theswallowable weight may be ablative in the presence of stomach fluids or may bedeflated to allow the guide element to be removed while the nasogastric tube remainsin place. The inserter element is inserted through the patient's nasalpassages and optionally into the oropharynx. The weight is released and the patientswallows it into the stomach. The guide element is threaded through the guideelement retaining structure, and the nasogastric tube is safely inserted alongthe guide element into the patient's stomach.