To summarize the nursing experience of ultrasound-guided enteral nutrition support in a patient with severe acute pancreatitis (SAP) complicated by abdominal compartment syndrome (ACS). Key nursing interventions included: early assessment of nutritional risk; screening for contraindications to enteral nutrition (EN) using ultrasound; reducing intra-abdominal pressure to facilitate early EN initiation; ultrasound-assisted selection and placement of feeding access; and qualitative and quantitative assessment via ultrasound visualization to guide EN implementation and monitoring. Through nurse-led, ultrasound-guided EN management, the patient′s EN was safely and smoothly administered. After 13 days of treatment, the patient′s nutritional status improved, clinical condition stabilized, and he was successfully transferred to a general ward.