Objective To compare the efficiency and complication incidence of the 2 routes of enteral nutrition(EN), through naso-jejunal tube and nasogastric tube, for critically ill elderly patients with swallowing dysfunction in order to explore more safe and effective way of EN. Methods A total of 53 critically ill elderly patients with swallowing dysfunction admitted in our hospital from January 2012 to November 2014 were recruited in this study. They were randomly divided into 2 groups according to different routes of EN, indwelling naso-jejunal tube (n＝31), and indwelling nasogastric tube (n＝22). In 2 weeks after EN, the nutrition indicators, incidences of complications and clinical outcomes were observed and compared between the 2 groups. Results Compared with the patients using nasogastric tube, those with naso-jejunal tube had more significantly elevated prealbumin, and obviously lower incidences of gastrointestinal complications and aspiration pneumonia (P＜0.05). However, no significant difference was seen in mechanical ventilation frequency and mortality between the 2 groups (P＞0.05). Conclusion Naso-jejunal tube for EN is more safe and effective for the critically ill elderly patients with swallowing dysfunction.