Objective: To assess the application value of nasointestinal decompression tube (NDT) in patients with severe acute pancreatitis (SAP). Methods: Fifty-six patients with SAP were designated to NDT group (observation group) or nasogastric tube group (control group), with 28 cases in each group. The drainage volume through decompression tube, time to abdominal distention/pain relief and outcomes along with the dynamic changes in parameters of laboratory tests and scores calculated according to APACHE II and Binder’s classification were observed. Results: Compared to control group, in observation group, the daily average drainage volume of gastrointestinal decompression was increased, time to abdominal distention/pain relief and average hospital stay was shortened, conversion rate to open surgery was reduced (all P<0.05), but there was no significant difference in mortality between the two groups (P<0.05); the time intervals for the blood white blood cell (WBC) and C-reactive protein (CRP), serum amylase enzyme (AMS), lipase (LPS) and lactate dehydrogenase (LDH) to return to normal levels were reduced (all P<0.05); both APACHE II and Binder scores were significantly decreased from the day 2–8 (all P<0.05) and approahced the level of control group at day 10 post-hospitalization (P>0.05). Conclusion: Using NDT can significantly improve the condition of SAP patients, reduce the incidence of complications and rate of surgery, and shorten the length of hospital stay, so it is recommended for clinical use.