Background Oral nutrition supplements (ONSs) play an important role in the management of malnutrition. This aim of study was to examine whether a comprehensive intervention, combining ONSs, family-centered health education, and nutrition and medical consultations, could improve the nutrition and health status of malnourished older adults living in community dwellings. Methods A randomized controlled trial was conducted from October 2017 to May 2018 in Shanghai. All participants were screened using the Mini Nutritional Assessment-Short Form (MNA-SF). Participants with MNA-SF scores <= 11 and age >= 65 were selected. Participants with potential nutrition risk were randomized into two groups: intervention group (n = 101) were prescribed ONSs (400 kcal/day) and family-centered nutrition education (once every 2 weeks) and control group (n = 100) received only family-centered nutrition education. Anthropometric measurements, including weight and height, and nutrition and functional scales, including MNA-SF, grip strength, and activities of daily living scores, were collected at the beginning of the study and 12 weeks later. Results Of the 201 study participants, 182 completed the study (mean age, 75.48 +/- 7.47 years). After 12 weeks, nutrient intake improvements in the intervention group (+370.6 +/- 432.6 kcal/day, +17.6 +/- 24.1 g/day) exceeded that of the control group (-67.5 +/- 378.2 kcal/day, -0.9 +/- 16.7 g/day). In addition, improvements in weight, body mass index, and handgrip strength were significantly higher in the intervention vs control group (P < .05). Conclusion Comprehensive nutrition interventions improved nutrition status in malnourished older people living in community dwellings. Use of ONSs may be a good strategy to improve nutrition status and strength in community-dwelling older adults.