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Gastroparesis is a complex, difficult-to-manage condition of delayed gastric emptying that can result in a debilitating set of symptoms. Diagnosis involves objective measurement of gastric emptying delay. Treatment success is typically based on subjective improvement in patient-reported symptoms. Medical nutrition therapy is recommended as a primary management strategy, but patient compliance is an issue. Medical nutrition therapy recommendations are largely based on empirical evidence extrapolated from the physiological effect of food on gastric emptying in the absence of interventional trials. The purpose of this article is to present and assess available evidence on MNT strategies for symptom relief in adult patients with gastroparesis and provide an application to practice.