Objective To carry out evidence-based practice for the management of indwelling gastric tubes in gastroenterology patients, so as to provide a reference for improving the quality of nasogastric tube nursing care. Methods According to the admission time, 78 gastroenterology patients admitted from June to October 2024 were assigned to the control group, receiving routine indwelling nasogastric tube management.Another 71 patients admitted from November 2024 to March 2025 were assigned to the observation group, where the best evidence for indwelling gastric tube management was formulated and evaluated, with 17 pieces of evidence screened out.On this basis, 10 audit criteria were established, the barriers and facilitators were analyzed, and correspon-ding change strategies were formulated and implemented. The incidence of adverse reactions during and after the tube insertion, success rate of first-attempt intubation, patient satisfaction, and compliance rate of the the 10 audit indicators were compared between the two groups.Nurses′ knowledge scores related to nasogastric tube management were compared before and after the implementation of the protocol. Results After the application of evidence, the compliance rates of 9 audit indicators were significantly improved.The observation group had a significantly lower incidence of adverse reactions during indwelling nasogastric tube placement, and significantly higher success rate of first-attempt intubation and patient satisfaction compared with the control group.Nurses′ knowledge scores related to nasogastric tube management were also significantly increased (all P＜0.05). Conclusion Carrying out evidence-based practice for the management of indwelling gastric tubes in gastroenterology helps reduce adverse reactions, improve the first-attempt insertion success rate, enhance patient satisfaction, and promote standardized nursing practices.