Objective To determine the effects of enteral nutrition with glutamine and synbiotics on nutritional status and gastro-intestinal tolerance in the elderly hospitalized patients. Methods A total of 182 elderly inpatients undergoing enteral nutrition in our hospital from January 2013 to December 2016 were recruited in this study. They were randomly divided into control group (n=92, conventional enteral nutrition) and treatment group (n=90, conventional enteral nutrition and supplements of glutamine and synbiotics). Serum levels of albumin (ALB), prealbumin (PA) and hemoglobin (Hb) prior and 10 d post the treatment were measured and compared. Their gastrointestinal tolerance was observed. Analysis of data was conducted using SPSS statistics 17.0. Differences between groups were compared with Student’s t test or Chi-square test according to different types of data. Results After the treatment, serum levels of ALB [(37.16±4.94) vs (33.10±4.97)g/L], PA [(218.26±89.57) vs (175.12±88.42)mg/L] and Hb [(104.99±16.47) vs (97.04±16.86)g/L] were obviously increased (P<0.05). And the levels were significantly higher in the treatment group than the control group [ALB:(37.16±4.94) vs (34.67±4.51)g/L, PA:(218.26±89.57) vs (211.83±98.39)mg/L, Hb:(104.99±16.47) vs (102.20±20.35)g/L, P<0.05]. The treatment group also had lower incidence rates of diarrhea (6.67% vs 16.30%), bloating (7.78% vs 20.65%), nausea and vomiting (3.33% vs 10.87%) when compared with the control group (P<0.05). Conclusion Enteral nutrition with supplement of glutamine and synbiotcs can improve nutritional status and gastro-intestinal tolerance in elderly patients.