Objective To investigate the effects of enteral immunonutrition on recovery, nutritional status, immune function in elderly gastric cancer patients after total gastrectomy. Methods 68 cases of elderly gastric cancer patients postgastrectomy were randomly divided into total PN group, EN+PN group. PN group stopped PN after taking semifluid diet. EN+PN group were tube feeding 250ml saline at the first day, 400ml PN at the second day and stopped PN after increasing to 800~1200ml at the 4th day. The recovery, serum marker on nutritional status and immune function were evaluated and compared before operation and on the 1st, 7th day after operation. Results The levels of serum total protein, albumin, prealbumin were significantly decreased in 2 groups on the 1st day after operation (P<0.05), and they were significantly increasedin EN+PN group on the 7th days after operation (P<0.05). The levels of serum IgG, IgM, the helper cells (CD8+, CD4+) and ratio of CD4+, CD8+, (CD4+/CD8+) were significantly decreased in 2 groups on the 1st day (P<0.05) after operation, and IgG, IgM, CD8+, CD4+and CD4+/CD8+ were significantly increased in EN+PN group (P<0.05) on the 7th day after operation. There were no significant difference in postoperative complication between 2 groups (P>0.05). Conclusions Postoperative early usage of enteral immunonutrition can improve the nutritional status and enhance immunity in elderly gastric cancer patients.