Background: abdominal massage is a beneficial nonpharmacological intervention for enhancing overall health outcomes in preterm infants. The aim of the current study was to evaluate the effect of abdominal massage on physiological parameters and feeding outcomes among preterm infants. Methods: A singleblinded randomized controlled trial (RCT) design was utilized on a purposive sample of eighty four preterm infants from Neonatal Intensive Care Units at El Manial (Kaser Al Aini) and EL Monira Pediatric Hospitals that are affiliated to Cairo University from June 2023 to July 2024. were simply randomly assigned to two equal groups, namely study (abdominal massage) and control. Tools: three tools were utilized: preterm infant’s characteristics and medical record data sheet, physiological parameters’ record and feeding outcomes recording sheet including feeding tolerance criteria and preterm infants' weight. Results: there were no statistically significant differences between the study and control groups regarding their personal characteristics on admission. There were statistically significant differences regarding mean score of heart rate and respiratory rate While there was no statistically significant difference regarding the mean oxygen saturation between both groups. As well as there was a highly statistically significant difference in the mean score of feeding intolerance including abdominal circumference, abdominal distension, GVR, frequency of vomiting and frequency of defecation in the abdominal massage group. Also, the mean preterm infant weight gain in the abdominal massage was a highly statistically significant difference compared to control group. Conclusion: abdominal massage can be an effective non-pharmacological intervention to efficiently improve physiological parameters, significantly reduce gastric residual volume, vomiting episodes, and abdominal distention. Additionally, it has been associated with increased defecation frequency and therefore it promotes weight gain in preterm infants. Recommendation: Utilizing abdominal massage as a nursing care routine in enterally fed preterm infants.