The optimal amount of enteral nutrition to provide critically ill patients remains unknown. We performed a meta-analysis of randomized controlled trials to determine the effect of initial trophic feeding versus full enteral feeding in critically ill patients. Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials that initial trophic feeding compared to full feeding in critically ill patients were included. The primary outcomes was mortality. Secondary outcomes include: hospital length of stay; ICU length of stay; duration of mechanical ventilation; pneumonia and gastrointestinal (GI) intolerance. The four studies included in the meta-analysis enrolled a total of 1540 patients. There was no apparent difference in mortality rates between initial trophic group and full enteral feeding (relative risk [RR], 0.95; 95% CI, 0.74, 1.20; p=0.65). The hospital length of stay and ICU length of stay were not significantly shorter in the initial trophic nutrition group. The incidence of serious GI intolerance was 23% in the initial trophic group compared with 31% in the full enteral feeding group; this difference was not significan``t (RR, 0.66; 95% CI, 0.39, 1.12, p=0.12). And, there were no differences in other secondary clinical outcomes. In conclusion, this meta-analysis of critically ill patients showed that there was no significant difference in mortality rates between initial trophic and full enteral feeding group. These trials did not provide any evidence that initial enteral feeding amount affected clinical outcome.The optimal amount of enteral nutrition to provide critically ill patients remains unknown. We performed a meta-analysis of randomized controlled trials to determine the effect of initial trophic feeding versus full enteral feeding in critically ill patients. Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials that initial trophic feeding compared to full feeding in critically ill patients were included. The primary outcomes was mortality. Secondary outcomes include: hospital length of stay; ICU length of stay; duration of mechanical ventilation; pneumonia and gastrointestinal (GI) intolerance. The four studies included in the meta-analysis enrolled a total of 1540 patients. There was no apparent difference in mortality rates between initial trophic group and full enteral feeding (relative risk [RR], 0.95; 95% CI, 0.74, 1.20; p=0.65). The hospital length of stay and ICU length of stay were not significantly shorter in the initial trophic nutrition group. The incidence of serious GI intolerance was 23% in the initial trophic group compared with 31% in the full enteral feeding group; this difference was not significan`t (RR, 0.66; 95% CI, 0.39, 1.12, p=0.12). And, there were no differences in other secondary clinical outcomes. In conclusion, this meta-analysis of critically ill patients showed that there was no significant difference in mortality rates between initial trophic and full enteral feeding group. These trials did not provide any evidence that initial enteral feeding amount affected clinical outcome.