OBJECTIVE: To investigate the factors influencing inadequate enteral nutrition (EN) after radical gastrectomy for gastric cancer and its impact on clinical outcomes. METHODS: A retrospective analysis was conducted on 212 gastric cancer patients who underwent radical surgery and received EN at the Fourth Hospital of Hebei Medical University. Patients were divided into two groups based on whether they achieved 60% of their caloric needs by the sixth postoperative day. Univariate and multivariate logistic regression models were used to identify factors associated with inadequate EN. RESULTS: Inadequate EN was observed in 26.89% of the patients. Key factors associated with insufficient EN included delayed initiation of nutrition, increased intra-abdominal and central venous pressures, use of sedatives, and delayed early mobility (all P<
0.05). Patients with inadequate EN had longer hospital stays, delayed bowel recovery, higher postoperative complication rates, and lower overall and disease-free survival rates (all P<
0.05). CONCLUSION: Inadequate enteral nutrition is an independent risk factor for poor clinical outcomes in gastric cancer patients after radical gastrectomy. Early and adequate nutritional support is essential to improve recovery and long-term survival.