Objective This study aims to comparaethe method and clinical outcomes of the inverted nasojejunal tube placement and jejunostomy on patients undergoing Ivor-Lewis esophagectomy. Methods A total of 268 esophageal carcinoma patients who have undergone Ivor-Lewis esophagectomy between January 2010 and December 2013 participated this study. Feeding tubes were inserted via the inverted nasojejunal tube placement of 58 cases and by jejunostomy in 210 cases. We compared the clinical outcomes of two methods. Results Feeding tubes were successfully inserted in all patients during operation. No death or nutritional and metabolic disorders were documented during the observation period. Inverted nasojejunal tube placement group compared with jejunostomy group, the anus exhause recovery more faster, two groups are significant (P<0.01); though the anus bowel movement recovery time shorter than the jejunostomy group, two groups are unsignificant (P>0.05). An intestinal obstruction was observed in the jejunostomy group. Unplanned extubation occurred in two patients in inverted nasojejunal tube placement group. Conclusions Compared with jejunostomy, the method of inverted nasojejunal tube placement was a non-invasive technique, it was more convenient and practical, and it was easier to master. It was a safe and effective route of nutritional support, and was worthy of clinical application.