Background The aim of this study was to compare nasogastric (NG) feeding with nasojejunal (NJ) feeding when treating pediatric patients with acute pancreatitis (AP).Methods We performed a single-center,prospective,randomized,active-controlled trial involving 77 pediatric patients with AP from April 2014 to December 2017.The patients were randomized into two groups:the NG tube feeding group (34 patients) and the NJ tube feeding group (33 patients).The primary outcome measures included the enteral nutrition intoler-ance,the length of tube feeding time,the recurrent pain of pancreatitis and complications.Results A total of 62 patients with AP (31 patients for each group) came into the final analysis.No differences were found in baseline characteristics,pediatric AP score and computed tomography severity score between the two groups.Three (9.7％)patients in the NG group and one (3.2％) patient in the NJ group developed intolerance (relative risk =3.00,95％ confidence interval 0.33-27.29,P =0.612).The tube feeding time and length of hospital stay of the NG group were significantly shorter than those of the NJ group (P =0.016 and 0.027,respectively).No patient died in the trial.No significant differences were found in recurrent pain,complications,nutrition delivery efficacy,and side effects between the two groups.Conclusions NG tube feeding appears to be effective and safe for acute pediatric pancreatitis compared with NJ tube feeding.In addition,high qualified,large sample sized,randomized controlled trials in pediatric population are needed.