Abstract: Objective To investigate the effect of early enteral nutrition(EN)after total gastrectomy on nutritional status and hospitalized recovery of elderly patients with gastric cancer. Methods A total of 88 elderly patients with gastric cancer who underwent total gastrectomy were selected as study objects, and were randomly divided into control group and study group, with 44 cases in each group. The control group was given parenteral nutrition(PN)support after operation, and the study group was given early EN support after operation. All of the patients maintained their treatments for 7 days and then transferred to normal oral diet. The nutritional indicators such as levels of serum albumin(ALB), prealbumin(PA)and hemoglobin(Hb)were measured before operation and 7 days after operation in the two groups. The time to first exhaust and defecation, the time to semifluid food intake, hospitalization time and the occurrence of complications were compared between the two groups. Results The levels of ALB and Hb in the control group were significantly lower at 7 d after operation compared with operation before(P<0.05), no significant differences in the above indexes were found in the same time point in the study group(P>0.05), the observation group was significantly higher in above indicators than those in the control group at 7 d after operation(P<0.05). There was no significant difference in hospitalization time between the two groups(P>0.05). The time to first exhaust and defecation, time to semifluid food intake in the observation group was shorter than that in the control group, and the complication rate was lower than that in the control group(2.27% vs. 18.18%), the differences were statistically significant(P<0.05). Conclusion Early - EN can improve the nutritional status of elderly patients with gastric cancer after total gastrectomy, promote the recovery of hospitalization and reduce complications.