Objective To investigate the application effect of stepped decision-making combined feeding tolerance grading of earlyenteral nutrition management in postoperative patients with gastrointestinal tumors, and to provide references for clinical practice to reduce postoperative enteral nutrition intolerance and postoperative complications in patients and improve their nutritional status. Methods According to the hospitalization time, 60 patients with gastrointestinal tumors admitted from March to August 2024 were set as the control group and received the conventional enteral nutrition management. From September 2024 to February 2025, 60 patients were assigned to the observation group and received the stepped decision-making combined feeding tolerance grading of early enteral nutrition management. The two groups were compared in terms of enteral nutrition tolerance indicators, feeding interruption, nutrition-related outcome indicators, and postoperative complications. Results The incidence of enteral nutrition intole-rance, the number of enteral nutrition interruptions, and the incidence of postoperative anastomotic leakage in the observation group were significantly lower than those in the control group (all P<0.05). The levels of albumin, serum prealbumin, and hemoglobin in the observation group were significantly higher than those in the control group at 7 days after surgery (all P<0.05). There was no significant difference in the incidence of postoperative pulmonary infection and wound infection between the two groups (both P>0.05). Conclusion The stepped decision-making combined feeding tolerance grading of earlyenteral nutrition management can significantly improve early enteral nutrition intolerance symptoms in postoperative patients with gastrointestinal tumors, reduce feeding interruptions, improve postoperative nutritional status, reduce the occurrence of postoperative complications, and promote patient recovery.