Objective To investigate the effect of early transpyloric feeding (ETPF) on the risk of bronchopulmonary dysplasia (BPD) in very preterm/extremely preterm infants (gestational age <32 weeks). Methods A total of 87 very preterm/extremely preterm infants admitted to the Neonatal Intensive Care Unit of Xiamen Maternal and Child Health Hospital between April 2022 and December 2024 were included. According to the feeding tube placement method, infants were divided into an ETPF group (n=42) and an orogastric tube feeding (OGTF) group (n=45). Nutritional indicators, oxygen use, and the incidence of BPD were compared between the two groups. Multivariable logistic regression analysis was performed to evaluate the association between ETPF and the risk of BPD. Results Compared with the OGTF group, the ETPF group had a significantly lower incidence of feeding intolerance (P<0.05), higher milk volume and caloric intake at week 2 of hospitalization (P<0.05), and significantly shorter time to achieve full enteral feeding, time to reach an oral caloric intake of 110 kcal/(kg·d), and time to reach a total caloric intake of 110 kcal/(kg·d) (all P<0.05). The incidence of BPD was significantly lower in the ETPF group than in the OGTF group (P<0.05). Multivariable logistic regression analysis showed that ETPF was an independent factor associated with a reduced risk of BPD (OR=0.286, 95%CI: 0.089-0.922). Conclusions ETPF improves enteral feeding tolerance in very preterm/extremely preterm infants, enables earlier establishment of full enteral feeding, and reduces the risk of BPD.