Objective　To explore the key points of perioperative nursing measures and management of premature infants with congenital gastrointestinal diseases.　Methods　A retrospective analysis was conducted using clinical data from 36 children undergoing gastrointestinal surgery from November 2014 to June 2018. According to gestational ages, the patients were divided into groups A, B and C: group A (n=9), 25 weeks≤gestational age<28 weeks, group B (n=19), 28 weeks≤gestational age＜30 weeks, and group C (n=8), gestational age≥37 weeks. The three groups of children received fined comprehensive nursing care. The heart rate, pulse oxygen saturation (SpO2), mean artery pressure (MAP) and adverse reactions were recorded before operation (T0), after anesthesia induction (T1), 30 min after anesthesia (T2), one hour after anesthesia (T3), and at the end of operation (T4).　Results 　There were two patients who died within one week, while the other 34 were recovered and discharged. Compared with groups A and B, patients in group C presented higher body weight and remarkable less ages than those in group C (P<0.05). The SpO2 of group A was remarkably increased at T3 and T4, compared with the level at T0 (P<0.05). The incidence of hypoxemia, hypothermia and reintubation of group A were higher than those in groups B and C (P<0.05), where group B presented marked improvement in the incidence of hypoxemia, hypothermia and reintubation, compared with group C (P<0.05).　Conclusions　Comprehensive nursing care should be taken in perioperative period of premature infants, especially in the management of body temperature and respiration. Effective thermal insulation measures can improve perioperative safety, reduce the occurrence of postoperative complications and improve survival rate.