Objective To explore the application effect of endoscope-guided visualized placement of nasoenteral feeding tubes in critically ill patients.Methods A total of 100 critically ill patients undergoing placement of nasoenteral feeding tubes were divided into a control group and an experimental group chronologically, with 50 patients in each group.The control group were placed nasoenteral feeding tubes utilizing bedside blind placement, while the experimental group used endoscope-guided visualized placement.Results The first-attempt success rate of tube placement in the experimental group was significantly higher than that in the control group, its duration of tube placement was significantly shorter, and its fluctuations of average arterial pressure, heart rate, and oxygen saturation during the tube placement were significantly less than those in the control group (all P＜0.05).And the incidences of fecal occult blood, nasal mucosa bleeding, nasal mucosa oozing, and accidental tracheal entry in the experimental group were significantly lower than those in the control group (all P＜0.05).Conclusion Endoscope-guided visualized placement of nasoenteral fee-ding tubes can increase the first-attempt success rate, shorten the duration of tube placement, reduce the fluctuations in average arterial pressure, heart rate, and oxygen saturation during the placement process, and decrease the incidence of complications related to tube placement.