Objective To explore the practical effects of an optimized enteral nutrition management program for patients with severe traumatic brain injury under the medical alliance model.Methods A non-concurrent controlled study was conducted.Thirty-five patients admitted from May to August 2024 were assigned to the control group, and 35 patients admitted from September to December 2024 were assigned to the intervention group.The control group received routine care, while the intervention group received an enteral nutrition optimization management practice based on the medical alliance model.The nutritional status, incidence of gastrointestinal complications, and the knowledge, attitude, and practice (KAP) of enteral nutrition support among nursing staff from grassroot hospitals were compared on day 1, day 3, day 7, and day 14 of admission.Results Thirty-two patients in the control group and thirty-three patients in the intervention group completed the study.On day 14 significant differences were observed between the two groups in serum albumin, prealbumin, hemoglobin, mid-arm circumference, and triceps skinfold thickness (all P＜0.05).Significant differences in time, group, and interaction effects were also found (all P＜0.05).The complication rate (except for gastric mucosal lesions) in the intervention group was significantly lower than that in the control group (all P＜0.05).The KAP scores of nursing staff from grassroot hospitals on nutrition knowledge, attitude, and behavior were significantly improved (all P＜0.05).Conclusion The optimized enteral nutrition management practice based on the medical alliance model can improve the nutritional status of patients with severe traumatic brain injury in grassroot hospitals, reduce enteral nutrition-related complications, and enhance the KAP level of nursing staff in enteral nutrition support.