Objective  To investigate the effects of evidence-based nursing practice according to clinical practice guidelines on enteral nuttition tolerance in critical neurosurgical patients.  Methods   144 critical patients admitted to the intensive care unit of neurosurgical department in a tertiary hospital in Jingzhou City from January 2018 to November 2018 were selected by convenient sampling. 69 patients who were admitted from July to November 2018 were defined as the experimental group and 75 patients who were admitted from January to June 2018 as the control group.  The  control  group received  routine nursing care while the  experimental group  received  evidence-based nursing  intervention  based  on  clinical  practice  guidelines.The  incidence  rate  of  enteral  nutrition  intolerance  and feeding compliance rate were compared between the two groups. The nurses' scores of "knowledge, belief and practire of enteral nutrition"  were also compared between the two groups. Results   Compared with the control group, the incidence rate of enteral nutrition intolerance in the experimental group was significantly lower  (P<0.05). The compliante rate of 7  d feeding in the experimental group was  94.2%,the  difference  between the two  groups  was statistically significantly==12.585,P<0.001).The knowledge level of nurses on the  management of feeding intolerance  in  severe patients was  significantly  improved(P<0.05).Conclusion  The early introduction of evidence-based nursing practice based on clinical practice guidelines plays an important  role in improving enteral nutrition tolerance in critical neurosurgical patients.