Proper nutrition found to be an essential in health maintenance and restoration in the critically ill patient. Aim of the study was to evaluate the effect of early enteral nutrition guidelines on occurrence of gastrointestinal complications among acute lung injury patients. Design A quasi-experimental research design was used to conduct this research. This study was carried out at Trauma Intensive Care Unit at Assiut University hospital. Sample: was consisted of 30 patients in each group. Tools: Tool I: Modified patient assessment questionnaire, Tool II: Gastrointestinal complications assessment related to enteral nutrition. Methods: data about 30 patients receiving enteral nutrition before enteral nutrition guidelines were retrospectively compared with data for 30 patients admitted after implementation of the guidelines. Results of the present study showed Patients in the after intervention group had a lower gastrointestinal complications than before intervention group. Conclusion: Implementing early enteral nutrition guidelines reduce occurrence of gastrointestinal complications among acute lung injury patient in ICU Recommendations: Provision an educational programs for nurses about enteral nutrition guideline.