Nutrition in surgical patients: how soon is too soon? Purpose of review Preoperative nutrition support has been extensively studied; however, data on the timing of postoperative nutrition initiation are scarce. The current review focuses on the importance of early nutritional support in surgical patients and their impact on outcomes. Recent findings Early nutrition support during the postoperative course may be the most important step that can be taken toward preventing subsequent malnutrition-related complications. European Society for Parenteral and Enteral Nutrition guidelines recommends early nutrition to improve outcomes after surgery and accelerates the recovery. Moreover, nutritional support should be personalized, and disease process-based. Summary Existing studies appear to focus mostly on abdominal and gastrointestinal surgery. Further prospective observational and randomized clinical trials across different surgical populations will aid surgeons to better understand how early feeds in either form can reduce morbidity, quality of life, and increase recovery rates. Correspondence to Rifat Latifi, The Felicien Steichen Professor and Chairman of Surgery, School of Medicine, New York Medical College, Valhalla, New York, USA; Chief, Division of General Surgery; Director, Department of Surgery, Westchester Medical Center Health, Valhalla, New York, USA. E-mail: Rifat.Latifi@wmchealth.org Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved.