Purpose <p>Enteral feeding intolerance (EFI) is a common complication following laryngeal cancer surgery. Traditional Chinese Medicine (TCM) dietary therapy has shown potential in improving gastrointestinal function and enteral feeding tolerance. This study evaluated the effectiveness of a self-made TCM dietary therapy formula in improving EFI and explored its role in EFI management.</p> Methods <p>Patients with laryngeal cancer were randomly assigned to the intervention (<i>n</i> = 38) or control group (<i>n</i> = 42). The control group received standard enteral nutrition, whereas the intervention group received standard enteral nutrition plus 25&#xa0;g/day of self-made dietary therapy formula. Primary outcomes included EFI incidence, enteral nutrition infusion rate, and time to first bowel movement. Secondary outcomes were serum total protein and prealbumin levels.</p> Results <p>Compared to the control group, the intervention group had a lower incidence of EFI (50.0% vs 71.4%, <i>P</i> = 0.049), a higher mean enteral nutrition infusion rate (81.24% vs 73.77%, <i>P</i> = 0.009), and a shorter time to first bowel movement (82.34 ± 37.34&#xa0;h vs 101.51 ± 42.95&#xa0;h, <i>P</i> = 0.037). By postoperative day 7, the intervention group also exhibited higher serum total protein and prealbumin levels (67.30 ± 7.03&#xa0;g/L vs 62.94 ± 5.35&#xa0;g/L; 206.50 ± 58.06&#xa0;mg/L vs 162.22 ± 42.50&#xa0;mg/L; <i>P</i> = 0.040 and 0.012, respectively).</p> Conclusions <p>This TCM-based, food-grade dietary therapy formula was associated with a reduction in EFI incidence, improved tolerance to enteral nutrition, and better postoperative nutritional status in patients with laryngeal cancer.</p> Trial Registration <p>Registered in the Chinese Clinical Trial Registry (<a href="https://www.chictr.org.cn">www.chictr.org.cn</a>) under the identifier ChiCTR2400093790 (11/12/2024). Retrospectively registered.</p>