Abstract：Objective：To observe the clinical efficacy of transcutaneous electrical acupoint stimulation （TEAS） combined with enhanced recovery after surgery （ERAS） in treating postoperative intestinal paralysis in gastric cancer. Methods： A total of 100 patients with postoperative intestinal paralysis after gastric cancer surgery treated in Lishui Central Hospital from January to December 2023 were selected and randomly divided into a control group and an observation group （50 cases each） using the random number table method. The control group received conventional ERAS treatment，while the observation group received ERAS combined with TEAS. Both groups were treated for four days. The time to normal bowel sounds，flatus，and defecation，hospital stay duration，and hospitalization costs were compared between the two groups. Levels of serum gastric hormones [motilin （MOT）， gastrin （GAS）， substance P （SP） ， vasoactive intestinal peptide （VIP） ， somatostatin （SS） ， and neurotensin （NT）] and cholecystokinin （CCK） were compared at 2 days before surgery，1 day，2 days，3 days，and 6 days after surgery. Levels of CD3+ and CD4+，and the CD4+/CD8+ value were compared at 2 days before surgery and 6 days after surgery. Results：The observation group had shorter times to normal bowel sounds，flatus，and defecation，and hospital stay duration than the control group （P＜0.05），and lower hospitalization costs（P＜0.05）. At 1 day，2 days，3 days，and 6 days after surgery，VIP，NT，and CCK levels in both groups were higher than those at 2 days before surgery （P＜ 0.05）， while MOT， GAS， SP， and SS levels were lower than those at 2 days before surgery （P＜0.05）. The observation group had higher levels of MOT，GAS，SP，SS，and NT than those in the control group at the same time points （P＜0.05），and lower levels of VIP and CCK （P＜0.05）. At 2 days after surgery，VIP and CCK levels in both groups were lower than those at 1 day after surgery （P＜0.05）， while MOT， GAS， SP， SS， and NT levels were higher than those at 1 day after surgery （P＜0.05）. At 3 days after surgery，VIP and CCK levels in both groups were lower than those at 1 day and 2 days after surgery（ P＜0.05），while MOT，GAS，SP，SS，and NT levels were higher than those at 1 day and 2 days after surgery （P＜0.05）. At 6 days after surgery， VIP and CCK levels in both groups were lower than those at 1 day，2 days，and 3 days after surgery （P＜0.05），while MOT，GAS，SP，SS，and NT levels were higher than those at 1 day，2 days，and 3 days after surgery （P＜0.05）. At 6 days after surgery，CD3+ and CD4+ levels，and the CD4+/CD8+ value in both groups were higher than those at 2 days before surgery （P＜0.05），and the observation group had higher levels and ratio than those in the control group （P＜0.05）. Conclusion： TEAS combined with ERAS can help restore gastrointestinal function， improve cellular immune function， prevent postoperative intestinal paralysis， and reduce hospital stay duration and costs in patients with postoperative intestinal paralysis after gastric cancer surgery.