〔Abstract〕 Objective To analyze the effect of structured nutritional care in patients with stroke in intensive care unit (ICU). Methods A total of 140 ICU stroke patients diagnosed and treated in the First People's Hospital of Shangqiu from January 2020 to December 2020 were randomly divided into a control group and an observation group, with 70 patients in each group. Patients in the control group received routine nursing, patients in the observation group received structural nutrition intervention, and the nursing effect of the two groups was compared. Results After nursing, the score of National Institutes of Health stroke scale (NIHSS) in the observation group was lower than that in the control group, the difference was statistically significant (P < 0.05). After nursing, the levels of total protein, albumin and hemoglobin in the observation group were higher than those in the control group, with statistical significance (P < 0.05). After nursing, the levels of CD4⁺ , CD8⁺ and interleukin-6 (IL-6) in the observation group were lower than those in the control group, and the levels of CD4⁺ /CD8⁺ and interleukin-10 (IL-10) were higher than those in the control group, with statistical significance (P < 0.05). After nursing, the score of daily diet management behavior, dietary compliance behavior, dietary compliance behavior, family support attitude and total score of patients in the observation group were higher than those in the control group, with statistical significance (P < 0.05). Conclusion The implementation of structural nutrition management strategy for stroke patients in ICU can improve their immune function, promote their nutritional status and improve their neurological function.