A strong Spurs line-up were poor for most of the evening, although Harry Kane clipped the post after half-time.
Gent, eighth in the Belgian league, almost added a second as Milicevic's shot was tipped on to the post
.
The second leg is at Wembley on Thursday, 23 February.
Relive Gent 1-0 Tottenham as it happened
Spurs stutter to surprise defeat

Harry Kane is Tottenham's leading scorer this season with 16 goals Gent's
20,000-capacity stadium, the Ghelamco Arena, is host to a
Michelin-starred restaurant, but there was little to feast on for
Tottenham, who turned in a strangely listless performance.Mauricio
Pochettino had spoken before the match about how keen his players were
to put behind them a poor display in losing 2-0 at Liverpool in the
Premier League on Saturday.With that in mind, Pochettino selected a very strong side - with only two changes to the team beaten at Anfield.Dele
Alli skimmed an early shot wide from just outside the penalty area
after good build-up involving Harry Winks and Ben Davies, but that was
as good as it got in the opening half.Pochettino's decision to
move midfielder Moussa Sissoko out to the left at half-time led to a
lively spell from the visitors, during which Kane clipped the post.But
Sissoko looked increasingly lost, and the Tottenham head coach was
prompted into more tactical tweaks in an attempt to find an equaliser.Nothing worked - and Tottenham's frustration was summed up as Alli picked up a needless yellow card for dissent.Wembley worries and Kane concernThey may have more reason than Tottenham to look forward to their big night in north London.
Spurs stumbled at their temporary European home in this season's Champions League - failing to qualify from their group after losing at home to Monaco and Bayer Leverkusen.
Having gone into the match in Belgium as second-favourites to win the Europa League, behind only Manchester United, Pochettino's team now need a good Wembley performance just to stay in the competition.
The Spurs boss will be hoping that Kane is fit for that match, having picked up an injury in the second half. Pochettino indicated that the forward may not be risked when Spurs visit Fulham in the FA Cup on Sunday.
"We need to assess Harry Kane, he got a knock on his knee," Pochettino said.
"We need to refresh the team. In the end, it is Tottenham that will play Fulham on Sunday, it's not about the name of the player."
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