OBJECTIVES: To evaluate clinical outcome and direct medical cost using Kabiven and traditional peripheral partenteral nutrition for postoperative patients in ICU. METHODS: This is a restrospective study. Medical records of postoperative patients in ICU were reviewed by clinical pharmacists from July 2008 to July 2009. The retrieved patients were divided into two groups, kabiven group (n=49) and separate bottle group (SB) (n=50). Patients, characteristics were evaluated and compared between two groups. The measured outcomes were the clinical effectiveness and direct medical costs. One way ANOVA were used for analysis. RESULTS: There were no statistically significance difference in patients, characteristics between two groups. Survival rate was higher in kabiven group than in SB group (40 % vs 31 %, respectively). The length of stay in hospital in kabiven group was longer than in SB group (47.51 ± 38.63 vs 31.86 ± 21.99 days, respectively; p<0.015). Total direct medical costs of survivors in kabiven group was more expensive than in SB group ($11,976.9 vs $9,574.9,respectively ). CONCLUSIONS: Although the direct medical cost of kabiven group were higher than SB group, use of kabiven is likely to improve mortality rate of postoperative patients in ICU.