The concept of the enhanced recovery after surgery was to reduce trauma stress and ccelerate patient rehabilitation by optimizing perioperative management. Good nutrition status was conducive for patients to reduce the decomposition metabolism, improve clinical outcome, is an important part of the enhanced recovery after surgery. Preoperative screening and evaluation of patients before operation, and then nutritional intervention in patients with malnutrition was necessary. However, there is some controversy about the best indicators or methods of nutritional status, and implementation was not optimistic. Oral nutritional supplements which was convenient to operation, easy to manage, lower complications, good compliance, was the first choice for nutrition intervention, at least 7 to 10 days before surgery. Preoperative oral nutritional supplements not only benefit patients with severe malnutrition, but also benefit from severe malnutrition in patients with cancer of the digestive system who lost weight before surgery. Although the role of immune nutrition has been confirmed, and the perioperative application of immune nutrition has become consensus, the advantages of preoperative immunonutrition compared to the standard isocaloric and isonitrogenous formula are challenged. At present, there is no optimal combination and formula of immune nutrition, and the preparation of the standard formula also contains certain immunonutritional components, so the selection of preoperative nutritional preparation should be based on the actual situation.