In this study, the effects of the presence of multi-longitudinal vortex and various rotation angles between the pitches of alternating elliptical axis (AEA) tubes on heat transfer and pressure drop of turbulent flow were numerically investigated. Turbulent flow of water fluid was simulated at Reynolds numbers of 10,000-60,000. The turbulent flow and heat transfer in the tubes were discussed in terms of parameters such as static pressure, velocity magnitude, wall shear stress, turbulent intensity, performance evaluation criterion and the field synergy principle. The results demonstrate that most heat transfer occurs in the transition zone, but this also caused a high rate of pressure drop. Increasing the rotation angle between pitches from 60°to 80°increased the heat transfer, which increased the number of the multi-longitudinal vortices from four to eight and better mixed the cold fluid with the hot fluid near the tube wall on more paths. The friction factor decreased and the average Nusselt number increased as the Reynolds number increased. Both parameters increased as the angle of the pitch rotation increased. The performance evaluation criteria for all AEA tubes at a constant pumping power showed that the highest value (1.09) was achieved at a low Reynolds number (Re = 10,000) in the AEA 90°tube.