Background: The milieu of intensive care units (ICU), the meticulous management of critically ill patients, especially in terms of nutrition, is paramount. Malnutrition poses a serious threat, emphasizing the necessity to assess and enhance current nutritional care practices. Objective: This cross-sectional study aimed to evaluate the adequacy of nutritional care for ICU patients at Rajshahi Medical College Hospital and multiple multi-central base hospitals between 2020 and 2022. Methods: Data were collected from patient records, ICU nursing documentation, and direct patient or family interviews. A total of 100 ICU patients were included through a multistage cluster sampling design. Patient demographics, including age and gender, were analyzed concerning nutritional care practices. Results: The study found that the mean patient age was 54.8 ± 19.97 years, with 45.3% over 60. Male patients predominated, but females were notably older. Nutritional care practices in the ICU varied, with initial feeding starting on the second ICU Day for 66% of patients, mainly via enteral (57.2%) or oral (37%) routes. Patients achieved only 59.2% ± 37.78 of prescribed calories and 55.5% ± 30.04 of required protein, with adequate intake for only 16.2% and 10.7% of patients, respectively. Nutritional care practices varied, with most patients receiving nutrition support, yet inadequate energy and protein intake were common. This underscores the need for personalized ICU nutrition care. Conclusion: This study emphasizes the need for tailored nutritional care in the ICU, considering the diverse age groups and gender differences among patients. Further research and targeted interventions are warranted to optimize nutritional support for critically ill patients.