Objective To explore the effect of postpyloric enteral nutrition (EN) in patients with cervical spinal cord injury undergoing mechanical ventilation (MV). Method 70 patients with cervical spinal cord injury who were treated with MV in intensive care unit (ICU) of Second Affiliated Hospital of PLA Naval Medical University from September 2018 to September 2020 were randomly divided into two groups, nasointestinal tube group and nasogastric tube group. Among them, 4 cases in the control group withdrew from the experiment for some reason and the final two groups with 35 and 31 cases respectively. Blood urea nitrogen (BUN), hemoglobin (HB), serum albumin (ALB), prealbumin (PA) before treatment, 3 days, 7 days after treatment and before discharge, duration of MV, ICU hospitalization time and the incidence of reflux and abdominal distension were observed and compared. Result The PA level in nasointestinal tube group was significantly higher than that in nasogastric tube group before discharge [(339.2±105.7) mg/L vs (286.5 ± 86.5) mg/L] (P<0.05), the other nutritional indexes had no significant difference (P>0.05). Compared with nasogastric tube group, patients in nasointestinal tube group had shorter ventilator support time [3.0(2.0,8.0) d vs 6.0(3.0,11.0) d], lower incidence of abdominal distension[14.3% (5/35) vs 35.5% (11/ 31)], lower hospitalization time[9.0(8.0,12.0) d vs 12.0(9.0,15.5) d], and the differences were significant (P<0.05). Conclusion EN with nasointestinal tube can improve the nutritional status of patients with cervical spinal cord injury, shorten the duration of MV and ICU hospitalization time, and reduce the incidence of gastrointestinal complications.