Twisted elliptical tubes possess superior heat transfer performance due to their unique geometry. It is necessary to further explore their potential applications in high-efficiency heat transfer devices. This study conducted a numerical simulation investigation to analyze the flow boiling heat transfer characteristics of subcooled water inside twisted elliptical tubes. The results show that the spiral flow inside twisted elliptical tube causes the fluid with relatively small vapor volume fraction to tend to distribute near the wall, while also increases turbulence intensity and promotes interactions among bubbles. Moreover, increasing the aspect ratio of the twisted elliptical tube can effectively improve the heat transfer coefficient and has a relatively small impact on the pressure drop of the fluid in the tube. Simulation data show that when the aspect ratio increases from 1.41 to 1.80, the heat transfer coefficient of the pipe increases by 15.21 %, while the pressure drop increases by 3.34 %.