Feeding intolerance is a major nutritional problem in preterm infants; hence several trials were done to evaluate the efficacy of prokinetic use.Objectives: To evaluate the efficacy and safety of high oral dose of erythromycin to treat feeding intolerance in preterm infants.Design: This study was a prospective, randomized trial on 60 premature neonates suffering from feeding intolerance. Thirty newborns were given oral erythromycin 12.5mg/kg/dose every 6 hours and 30 newborns not given erythromycin. They compared as regards time to reach full enteral feeds, duration of parenteral nutrition, episodes of gastric residual, weight gain and duration of hospital stay.Results: For preterm <32 weeks, there was significant weight gain and also significant reduction in number of episodes of gastric residuals.Conclusion: High dose erythromycin is associated with better tolerance in preterm <32 weeks gestational age.