BackgroundEnteral nutrition is widely recommended in intensive care units, but its implementation is accompanied by some problems. AimThis study aimed to develop a current-evidence-based, operable and repeatable ultrasound-guided enteral nutrition (EN) programme for critically ill patients. Study DesignFirst, based on a literature review, we integrated guidelines, expert consensus, systematic review and clinical experimental studies on critically ill patients. Subsequently, after careful evaluation and selection of relevant EN management data, we formulated a preliminary draft of an ultrasound-guided EN protocol for critically ill patients. Based on feedback from Delphi experts, the protocol was revised, and the final version of the programme was constructed. ResultsAfter two rounds of consultation, the expert opinions reached a consensus. The expert positive coefficient was 1.00, and the expert authority coefficient was 0.935. After the second round of consultation, the coefficient of variation for the importance score ranged from 0.04 to 0.19, and that for the feasibility score ranged from 0.04 to 0.21. The difference in Kendall harmony coefficients was statistically significant (p < .05). The final programme comprised four Level I, 15 Level II and 40 Level III projects. ConclusionsThe EN protocol for critically ill patients established in this study is comprehensive and feasible and can provide guidance for clinical practice. Relevance to Clinical PracticeThis study adopted the Delphi method to develop an ultrasound-guided EN programme for critically ill patients, providing a new protocol by which critical care nurses can implement EN. This protocol provides a reliable and comprehensive basis for ensuring the quality and safety of EN management in critically ill patients in the future.