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BACKGROUND Whether early enteral nutrition with probiotics can reduce the mortality and infection rate of severe craniocerebral injury (SCI) patients, improve their gastrointestinal function and shorten the length of stay in intensive care unite (ICU) have not been determined. METHODS PubMed, China National Knowledge Infrastructure, Embase were electronically searched for the purpose of identifying the randomized controlled trials investigated the potential of early enteral nutrition supplemented with probiotics on patients with SCI from the establishment of databases to August 26, 2019. STATA software (Version 12.0; Stata Corporation) was used to perform meta-analysis. RESULTS Totally 39 trials enrolling 3387 patients were included. Early enteral nutrition supplemented with probiotics was associated with decreased risk of infection (pooled RR=0.486, 95%CI: 0.394-0.599). Decreased risk of the 7-day, 14-day and 28-day mortality (pooled RR=0.415, 0.497 and 0.385; 95% CIs: 0.196-0.878, 0.297-0.833 and 0.197-0.751, respectively), decreased risk of gastrointestinal complications (pooled RR=0.363, 95%CI: 0.274-0.481). Shortened the time course recovery of enteral function. Shortened the length of stay in hospital and length of ICU stay (SMDs = -3.327 and -1.461; 95% CIs: -6.213--0.440, and -2.111--0.811, respectively). CONCLUSION Enteral nutrition supplemented with probiotics effectively decreases the risk of mortality, gastrointestinal complications, and infection, as well as shortens the stays in ICU, and thus it should be extensively adopted to manage these given patients.