OBJECTIVE: The aim of this study was to examine the effects of pacifier use alone and combined with human milk on vital signs, feeding duration, and gastric residue in preterm infants during orogastric tube feeding. METHODS: In total, 90 preterm infants (gestational age 29+0 to 34+0 weeks) were randomly assigned to three groups: pacifier group, pacifier with human milk group, and control group. During feeding, the pacifier group received only a pacifier, while the pacifier with human milk group received a pacifier with 1-2 mL of human milk. The control group received no intervention. RESULTS: Groups were homogeneously distributed based on descriptive characteristics. Feeding duration was significantly shorter in both intervention groups compared to the control group. Additionally, heart and respiratory rates measured after feeding were significantly lower in these groups than during feeding. CONCLUSION: These findings suggest that pacifier use, with or without human milk, may be associated with more stable physiological responses after feeding and more efficient feeding in preterm infants. Clinical Trial Registration Number: This study was prospectively registered at ClinicalTrials.gov, registration NCT05530733.