Objective To track the trajectories of supportive care needs in rectal cancer patients at different time points, and to explore the influencing factors of the trajectories. Methods A total of 267 inpatients having an enterostomy in place after surgical treatment of low-lying rectal cancer were enrolled, and surveyed at 1(T1), 3(T2), 6(T3) months post-surgery. Latent class growth analysis was used to identify trajectories of enterostomal patients′ supportive care needs. The influencing factors of the trajectories were analyzed by running logistic regression analysis. Results Totally, 249 patients completed the whole follow-ups. Three trajectories of enterostomal patients′ supportive care needs emerged: the persistently high group(20.5%) ,the rapidly descending group (43.8%) ,the slowly descending group (35.7%). Logistic regression analysis showed that age, education levels, household per capita monthly income, chemotherapy, complications, chronic diseases and ostomy adjustment scores influenced the trajectories of patients′ supportive care needs. Conclusion The supportive care needs of enterostomal patients have a downward trend within 6 months post discharge. There is group-based heterogeneity in their supportive care needs. Medical staff should formulate precise intervention measures tailored to predictors of supportive care needs at different stages, striving to satisfy the supportive care needs of enterostomal patients.