Abstract:〔Abstract〕 Objective To investigate the effect of combined swallowing assessment in early enteral nutrition in patients with acute stroke. Methods A total of 94 patients with acute stroke admitted to Xinyu People's Hospital from January 2023 to January 2024 were selected to receive early enteral nutrition, and were divided into a control group and an observation group by random number table method, with 47 cases in each group. The control group was evaluated by the lowland drinking water test, and the observation group was evaluated by the volume-viscosity swallow test (V-VST) on the basis of the control group. Both groups were continuously observed for 4 weeks. The swallowing function, nutritional status, complication rate and quality of life were compared between the two groups. Results After intervention, the functional oral intake scale (FOIS) score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After intervention, the levels of hemoglobin, serum albumin and serum total protein in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The total incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05). After intervention, the all dimensions scores of 36-item short form health survey (SF-36) in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Combined swallowing assessment in early enteral nutrition of acute stroke patients is helpful to improve swallowing function, improve nutritional status, reduce the risk of complications, and promote the quality of life of patients.