Objective To observe the effects of individualized home enteral nutrition support on body mass index (BMI), incidence of malnutrition, postoperative body weight loss and nutritional indexes in patients on tube feeding after radical esophagectomy. Methods Patients on home enteral nutrition tube feeding after radical esophagectomy treated in Shanghai Chest Hospital, Shanghai Jiao Tong University from 2018 to 2019 were selected, including 136 patients who received routine home enteral nutrition education from Jan. to Dec. 2018 (control group) and 146 patients who received routine home enteral nutrition education+individualized nutrition diet intervention from Jan. to Dec. 2019 (intervention group). The changes in body weight, BMI, incidence of malnutrition, weight loss and nutritional indexes were compared between the 2 groups before and after nutrition intervention. Results There were no significant differences in weight, BMI or incidence of malnutrition between the 2 groups at discharge (all P>0.05). However, the nutritional indexes (total protein, albumin and lymphocyte count) of the intervention group were significantly lower than those of the control group (all P<0.05). After 3 weeks of nutrition intervention, there was no significant difference in body weight or BMI between the 2 groups (both P>0.05); the incidence of malnutrition of the intervention group was significantly lower than that of the control group (17.8%[26/146]vs 27.9%[38/136], P<0.05); the changes of body weight loss and BMI of the intervention group were significantly lower than those of the control group (both P<0.001); and the total protein and prealbumin levels were significantly higher than those of the control group (both P<0.05). Conclusion Home enteral nutrition support combined with individualized whole-course nutrition guidance can significantly prevent postoperative body weight loss, reduce the risk of postoperative malnutrition and improve postoperative nutritional status in patients on tube feeding after esophageal cancer surgery.