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Nutrition assessment is a means of identifying critical care patients at greatest risk for complications. It should include manifestations both of disease-related malnutrition and starvation. Critically ill patients are at risk for accelerated loss of lean body mass with even greater loss of weight if nutrient intake is poor or absent. Recognizing those patients who are unable to eat and barriers that interfere with adequate nourishment are important aspects of clinical decision-making. This chapter discusses at risk patient populations, dietary intake analysis, delays and obstacles to feeding, nutrition-focused history and physical examination, laboratory evaluation, and body composition assessment. The multidisciplinary critical care team should discuss relevant components of the nutrition assessment daily. Ongoing evaluation of nutrition adequacy is essential for optimal patient care.