According to the latest World Health Organization report, stroke is the second leading cause of death worldwide [1]. In 2016 alone, around 5.5 million people died of stroke [2]. China has one of the world’s heaviest stroke burdens; according to the latest census, the incidence of stroke in China is about 1.6% [3]. Damage to nerve function due to stroke affects gastrointestinal hormone and neurotransmitter secretion. In turn, this affects intestinal mucosa function, which leads to obstacles in the digestion and absorption of intestinal nutrients. Therefore, to ensure the body’s nutritional supply, it is necessary to implant a nasogastric tube for enteral nutrition (EN). At present, the clinical nutritional support treatment consists primarily of parenteral nutrition and EN [4, 5]. However, long-term use of parenteral nutrition [6] may cause adverse reactions, such as catheter complications and intestinal mucosal injury. Additionally, EN promotes the proliferation of intestinal mucosal cells and maintains the gastrointestinal barrier function. Therefore, there is a low incidence of adverse reactions to EN. However, due to severe gastrointestinal dysfunction, patients with severe stroke are prone to complications such as diarrhea, constipation, and infection within 1 to 2 weeks after receiving EN support. This inhibits both the implementation and the effect of EN [7]. Probiotics are active microorganisms that are beneficial to the host and can form colonies in the human intestine. A balanced gut microecology has a positive and healthy effect on the human body. Wong [8] found that timely supplementation of probiotics can reduce intestinal permeability in critically ill patients, reduce pathogenic toxins and gas production, reduce abdominal distension, neutralize food allergies, reduce irritable bowel symptoms, and improve EN tolerance. As such, if a suitable entry point can be located, probiotics can be an effective treatment. Several clinical studies have confirmed the positive effects of probiotics in patients with stroke. However, due to the varying quality and sample sizes of these studies, there is no systematic means to evaluate the effects and safety of probiotic treatment combined with EN. Therefore, in this meta-analysis, we have consolidated published literature and provided a systematic review of evidence for the application of probiotics in patients with stroke.