Turbulent hydrothermal characteristics in a double-pipe heat exchanger with an internal twisted elliptical tube (TET) are investigated. The impacts of aspect ratio (AR = 1.4–2), uniform twist pitch (p = 100 mm-400 mm), and non-uniform twist pitch (five cases) on flow stream characteristics and heat transfer of parallel and counter-flows are investigated numerically. Utilizing a TET with a non-uniform twist pitch as an innovative approach yields noteworthy results, particularly in contrast to the traditional use of TETs with uniform twist pitch, owing to the longitudinal asymmetry. The outcomes depict that the pressure drop and heat transfer augment as the uniform twist pitch declines and the AR rises. The counter-flow has a more significant average Nusselt number than the parallel-flow by about 2–4 % without increasing the friction factor. Still, in some cases of non-uniform twist pitch, the average Nusselt number of the parallel flow is even 4 % higher than the counter-flow. The case with p = 100–200–400 mm (three parts with various twist pitches) and parallel-flow exhibits the most significant performance evaluation criterion (PEC) among the non-uniform twist pitch. As the aspect ratio increases from AR = 1.4 to AR = 2, the PEC factor in the counter-flow mode increases; however, there is an out-of-trend point at AR = 2 for the parallel-flow mode. The PEC factor augments about 8.47 % and 6.16 % for the counter-flow and the parallel-flow modes, respectively. The growth of TET twist pitch by 300 % reduces PEC by about 13.3 % in the counter-flow. The most significant PEC value is 1.166, which belongs to the case with the counter-flow condition and p = 100 mm.