Objective To discuss the effects of early nutraceuticals support and homemade homogenate diet in patients with severe traumatic brain injury(sTBI). Methods From January 2018 to June 2019, 84 sTBI patients were selected from the No.2 peoples′ hospital of Yibin and divided into nutraceuticals group and homemade homogenate diet (HDD) group randomly, patients in 2 groups were fed with off⁃the shelf nutraceuticals and HHD respectively, the nutritional indexes, adverse reactions/complications, Glasgow Coma Score (GCS) and hospitalization expenses were observed after 4 weeks. Results ① After nutrition support for 2 weeks or 4 weeks, hemoglobin (HB), albumin (ALB), prealbumin (PA), transferrin (TF), lymphocyte count (LYM), calf circumference (CC) and triceps skinfold (TSF) in nutraceuticals group were significantly higher than HHD group (besides TF after nutrition support 2 weeks, P<0.05). ②The incidence of pathoglycemia, diarrhea and total adverse reaction/complications in nutraceuticals group was significantly lower than HHD group (pathoglycemia: 14.3%：35.7%; diarrhea: 11.9%：40.5%; total incidence: 15.5%：25.0%, P<0.05). ③After nutrition support 2 weeks and 4 weeks, GCS in nutraceuticals groups were significantly higher than HHD group［2 weeks：(8.88±1.50) point (7.76±1.72) point；4 weeks：(10.26±2.40) point (8.86±2.14) point，P<0.05］. ④There was no difference of total hospitalization expenses and daily hospitalization expenses between 2 groups (P>0.05), daily nutrition support cost in nutraceuticals group was higher than HHD group ［(356.3±43.9) yuan (159.4±39.4) yuan, P<0.05］. Conclusion Compared with homemade homogenate diet, nutraceuticals support could be more beneficial to promote nutritional status of sTBI patients, reduce the incidence of insulin resistence, diarrhea or other complications, improve the prognosis of sTBI patients with possible better cost⁃effectiveness.