The study investigated the effects of sequential enteral nutritional support in 115 elderly patients with severe ischemic stroke after thrombectomy from January 2022 to January 2024. Patients were divided into a control group (n=57) with routine enteral nutrition and an intervention group (n=58) with sequential enteral nutrition. The intervention group had higher levels of albumin (ALB), total protein (TP), prealbumin (PA) and hemoglobin (Hb) on the 14th day after the intervention (p < 0.05). She also showed higher immunoglobulin M (IgM) and immunoglobulin G (IgG) levels (p < 0.05), lower NIHSS scores, higher Glasgow Coma Scale (GCS) scores, and higher Barthel Index (BI) at discharge (p < 0.01). In addition, she had a lower gastrointestinal dysfunction score on day 14 and fewer complications (p < 0.05). Sequential support of enteral nutrition improved short-term nutritional status, immune functions, neurological scores and daily living capacity.