[Objectives]  To examine the effects of sequential infection by the Chinese sacbrood virus and Nosema ceranae on the survival rate, nutritional metabolism and immunity of Apis cerana cerana. [Methods]  The three groups of bees were fed normal food, CSBV first and then N. ceranae, N. ceranae first and then CSBV and the proliferation of CSBV and N. ceranae in each group was detacted with PCR. The number of CSBV and the expression of nutritional metabolism genes (ilp1, ilp2, hexamerin70b, hexamerin70c) and immune genes (toll, relish, jra, apidaecin, abaecin, defensin, hymenoptaecin, JAK) were detected by RT-qPCR. [Results]  CSBV and N. ceranae infection significantly reduced the survival of A. cerana cerana, and the number of spores in the group fed CSBV first was higher than that in the group fed N. ceranae first. At the time of CSBV inoculation, the proliferation of CSBV in the group fed CSBV first was significantly higher than that in the group fed N. ceranae first. The expression levels of nutritional metabolism genes decreased gradually over time in the group fed CSBV first, but increased significantly in the group fed N. ceranae first. In the group fed CSBV first and then N. ceranae, the expression of immune genes toll and relish increased first and then decreased, and the expression of jra, apidaecin, abaecin, defensin and hymenoptaecin increased significantly, while the expression of these eight immune genes increased significantly in the group fed N. ceranae first and then CSBV. [Conclusion]  Infection with N. ceranae inhibited the proliferation of CSBV to a certain extent, whereas infection with CSBV accelerated the proliferation of N. ceranae. Infection with CSBV first has a stronger impact on the nutrition, growth and development of honeybees than feeding N. ceranae first. Bees that were first infected with CSBV mobilized their immune defense more effectively than those that were infected with N. ceranae first. This illustrates the complexity of the interaction between the immune response and the nutritional metabolism caused by the sequential infection of workerbees by CSBV and N. ceranae.