Abstract: Objective To observe the influence of early enteral nutrition(EEN) on intestinal barrier function and prognosis in patients with severe pneumonia(SP) combined acute gastrointestinal injury(AGI). Methods Total 60 patients with SP and AGI Ⅱ admitted to the ICU of the Second Affiliated Hospital of Bengbu Medical Collage from January 2018 to December 2019 were randomly divided into observation group(EEN group) and control group(LEN group), 30 cases in each group. The observation group received EN within 24-48 hours, while the control group received EN after 72 hours. The feeding intolerance rate, length of ICU stay, length of mechanical ventilation, APACHE Ⅱ score, 28-days mortality(20.00% vs. 23.3%), and levels of D-lactate, diamine oxidase(DAO), procalcitonin(PCT), C-reactive protein(CRP) were compared between the two groups. Results No significant differences were found on feeding intolerance rate and 28-days mortality between the two groups(all P>0.05). The length of ICU stay, length of mechanical ventilation, APACHE Ⅱ score after treatment in the observation group were shorter than those in the control group(all P<0.05). After treatment, the levels of serum D-lactate, DAO, PCT and CRP decreased in both groups, and those in the observation group was obvious lower than those in the control group(all P<0.05). Conclusion EEN can improve intestinal barrier function, reduce inflammation, and with a low incidence rate of feeding intolerance in patients with SP combined AGI. However, it has no ameliorative effect on short-term prognosis.