Objective To compare the effects of enteral immunonutrition on recovery, nutritional status, immune function, quality of life in patients with Siewert II/III adenocarcinoma of esophagogastric junction received proximal gastrectomy plus jejunal interposition versus total gastrectomy. Methods 42 cases of Siewert II/III adenocarcinoma of esophagogastric junction patients were randomly divided into proximal gastrectomy plus jejunal interposition group (PG) and total gastrectomy group (TG). Postgastrectomy enteral immunonutrition therapy was early used in two groups. The changes of recovery, serum markers, nutritional status, immune function were evaluated on 1st day and 5th day postoperation. Quality of life were compared in 12 months postoperation. Results There were no significant difference neither in postoperative complications nor in levels of serum total protein, albumin, prealbumin and IgG, IgA, CD3+, CD4+, CD4+/CD8+ between 2 groups on the 5th day postoperation (P>0.05). The levels of weight loss and hemoglobin in PG+ jejunal interposition group was significantly increased (P<0.05) than TG group on 12 months after operation, no significant difference was seen in reflux symptoms between 2 groups. Conclusions Early usage of enteral immunonutrition in Siewert II/III adenocarcinoma of esophagogastric junction received PG+jejunal interposition can improve recovery, nutritional status and enhance immunity. PG+jejunal interposition was better than TG in postgastrectomy function reservation and life quality.