Due to the low heat transfer efficiency of common heat exchange systems, an improved heat exchange system was developed. Enhanced tubes (elliptical tubes with a built-in turbulator) instead of a smooth tube were used and TiO2-water nanofluids were substituted for water to intensify the heat transfer. The influences of turbulator (presence or absence), axial ratios of elliptical tubes (Z=1.235, 1.471, 1.706), nanoparticle concentration (ω=0.0 wt%, 0.1 wt%, 0.3 wt%, 0.5wt%), and Reynolds number (Re=400-12,000) on the flow and heat transfer properties of TiO2-water nanofluids were studied. Thermal and exergy efficiency were used to research the comprehensive thermo-hydraulic characteristics of these heat transfer enhancement technologies. The thermo-hydraulic properties of nanofluids all showed an increasing trend with the growing axial ratio, nanoparticle concentration and Reynolds number. Nanofluids (ω=0.5 wt%) in an elliptical tube (Z=1.706) with a built-in turbulator showed the best thermal performance, which could be increased by 33.8% in comparison with water at best. The thermal efficiency index increased first and then decreased with the Re. Nanofluids in elliptical tubes with a built-in turbulator can clearly promote heat transfer under the identical condition.