Objective: To investigate the success rate and influencing factors of spiral nasojejunal tube in brain injured patients. Methods: Form September 2007 to March 2008, consecutive brain injured patients who admitted to the Intensive Care Unit were enrolled in this perspective cohort study. After patient's admission, a spiral nasojejunal tube was inserted and the positions of these tubes were observed 24, 48, and 72 hours after the insertion. Postpyloric progression of the tube was assessed by auscultation, liquid aspiration plus pH test, and abdominal X-ray examination. Tube position was confirmed by X-ray. The severity of disease, therapeutic measures, agents administered, and average 24-hour fluid balance within 72 hours after tube insertion were recorded. Factors influencing tube progression were analyzed by multivariate Logistic regression models. Results: Totally 83 patients with complete clinical data were enrolled for analysis. The postpyloric progression rate was 68.7% 72 hours after tube insertion. Using X-ray as the golden standard for indication of postpyloric migration,\ the diagnostic rate of liquid aspiration plus pH test (90.7%) was significantly higher than that of auscultation (65.6%). The influencing factors included Glasgow Coma Scale score, surgeries performed or not, mechanical ventilation, and urapidil hydrochloride. Conclusions: The progression rate of spiral nasojejunal tubes progressed from stomach to postpyloric position was 68.7% of brain injured patients in our study. These tubes may facilitate early small bowel feeding in brain injured patients.