Objective To select and obtain the evidence on prevention and management of enteral nutrition associated abdominal distention in ICU patients, so as to provide decision evidence for medical staff. Methods According to the evidence pyramid 6S model, all evidences on prevention and management of enteral nutrition associated abdominal distention in ICU patients were retrieved by searching databases, such as Best Practice, UpToDate, Joanna Briggs Institute(JBI), ASPEN, Cochrane Library, PubMed, CNKI, SinoMed, etc. Combined with the judgement of clinical professionals, the related evidences were extracted and summarized from quality standardized literature. Results Twenty-four articles were included, and 17 best evidences (14 level A recommendation, 3 level B recommendation) were extracted and summarized, which were consisted of the definition, assessment, position and pharmacy intervention, enteral nutrition intervention, intra-abdominal pressure monitoring, traditional Chinese medicine nursing of enteral nutrition associated abdominal distention. Conclusion The quality of the 17 extracted evidences are high, which can be used for the prevention and management of enteral nutrition associated abdominal distention in ICU patients.