Objective To systematically evaluate the complications associated with enteral nutrition by nasogastric and nasointestinal tube in severely brain-injured patients. Methods Randomized controlled trials regarding the complications of enteral nutrition by nasogastric and nasointestinal tube in severely brain-injured patients were retrieved in such electronic databases as PubMed, OVID, Cochrane Library, Chinese Journal Full-text Database （CNKI） and Wanfang database. Quality of the literature was measured and Revman5.3 software was employed to conduct meta-analysis. Results Fifteen RCT studies were included involving 1059 samples. The results of meta-analysis showed that the incidence rates of reflux, aspiration, pulmonary infection and bloating were significantly lower in patients using nasointestinal tube compared with those using nasogastric tube （P＜0.01 for all）, but there were no significant differences in diarrhea and gastrointestinal bleeding （P＞0.05 for both）. Conclusion Nasointestinal tube is superior to nasogastric tube in enteral nutrition, which can effectively reduce the incidence of reflux, aspiration, pulmonary infection and bloating in patients with severe head injury.