Objective To observe the effect of early enteral nutrition combined with probiotics for acute severe stroke patients. Methods EiGhty-seven patients with acute severe stroke were randomly divided into control Group(47cases)and research Group(40 cases). Within 48 -72 h,both Groups were Given enternal nutrition,and research Group added probiotics on the basis of enternal nutrition. HemoGlobin( Hb ),serum albumin(ALB)and prealbumin(PLB)were detected on the lst,7th,2lth day after hospitalization. Infection incidence and the incidence of the Gastrointestinal adverse reaction were observed on the 7th,2lth day. GlasGow coma scale( GTS)and NeuroloGic impairment sccore( NIHSS)were assessed on the lst,2lth day. Results There were no satistical siGnificant differences between two Groups in terms of ALB,PLB and Hb on the first day after hospitalization(P>0. 05). The indicators of the two Groups occurred downward trend on the 7th day and control Group declined siGnificantly( The two Groups respectively:ALB:( 3l. 27 ±2. 42 ) G/L and( 27. 2l ±2. 69)G/L,P<0. 00l;PLB:(0. l78 ±0. 0ll)G/L and(0. l65 ±0. 023)G/L,P <0. 00l;Hb:(ll2. 4l ±2. 3l)G/L and(97. l3±l. 79)G/L,P<0. 00l). The two Groups occurred upward trend on the 2lth day and research Group rose siGnificantly( The two Groups respectively:ALB:( 35. 89±2. 98 )G/L and( 30. 24±2. ll ) G/L,P<0. 00l;PLB:(0. 208±0. 022)G/L and(0. l98±0. 029)G/L,P<0. 00l;Hb:(ll9. ll±3. 42)G/L and(l08. 36±2. 63)G/L,P<0. 00l). There were no statistical siGnificant differences between the two Group in terms of infection incidence and the Gastrointestinal adverse reaction on the 7th day. The incidence of control Group were hiGher than research Group on the 2lth day(The two Groups respectively:pneumonia:7(l4. 8%)and l4(35. 0%),χ2 =4. 467,P =0. 035;enteric infection:2(4. 2%)and 8(20. 0%),χ2 =5. 06l,P =0. 024;vomit:0 and 2(5%),χ2 =6. 077,P=0. 0l4;abdominal distension:5(l0. 6%)and ll(27. 5),χ2 =3. 859,P=0. 049;diarrhoea:4(8. 5%)and l0(25. 0%),χ2 =4. l27,P=0. 042;flora imbalance:4(8. 5l%)and 9 (22. 5%),χ2 =4. l53,P=0. 046). On the 2lth day,the GTS and NIHSS were hiGher than the first day,but there were no statistical sinificant differences between two Groups( P>0. 05). Conclusion Enteral nutrition add probiotics is superior to enteral nutrition on the aspects of enhancinG body nutrition situation,relievinG the infection and the Gastrointestinal adverse reaction.