Objective To explore the application effect of intestinal oxygenation monitoring in postoperative enteral nutrition of children with high intestinal atresia. Methods A total of 96 children with high intestinal atresia admitted to the department of neonatal surgery were selected as study subjects using convenience sampling. The children were divided into two groups based on admission time: the control group consisted of 48 children admitted from July 2018 to December 2020, and the observation group consisted of 48 children admitted from January 2021 to June 2023. Both groups received total parenteral nutrition support after surgery. In the control group, enteral nutrition was initiated according to the doctor′s advice after 48 hours postoperation, and the feeding mode was adjusted based on tolerance during feeding. In the observation group, intestinal oxygenation monitoring was conducted immediately after surgery, and enteral nutrition commenced when the intestinal oxygenation value reached ≥0.77 after 24 hours. Ente-ral oxygenation was continuously monitored during feeding, and adjustments were made to enteral nutrition based on monitoring results. The first initiation time for enteral nutrition, total duration of oral feeding, body weight changes during hospitalization, incidence rates of necrotizing enterocolitis and feeding intolerance, as well as the length of hospital stay were observed. Results The first postoperative enteral nutrition time in the observation group was significantly lower than that in the control group, the increase of body mass during hospitalization was significantly higher than that in the control group, and the incidence of feeding into-lerance was significantly lower than that in the control group (all P＜0.05). There was no significant difference in total oral feeding time, hospital stay and incidence of necrotizing enterocolitis between the two groups (all P＞0.05). Conclusion The guidance of postoperative enteral nutrition based on intestinal oxygenation monitoring data is more conducive to shortening the first postoperative enteral nutrition time and reducing the occurrence of feeding intolerance, which is conducive to the growth and deve-lopment of children with high intestinal atresia.