In this paper, the flow condensation heat transfer characteristics of the environmentally friendly nearly-azeotropic refrigerant R1234ze(E)/R152a (mass ratio of 40:60) in smooth tubes with varying structures were numerically investigated. Under the operating conditions of mass flux of 400 kg/m2/s, heat flux of 12 kW/m2, and saturation temperature of 308.15 K, this study investigated the influence of circular tube inner diameter, elliptical tube aspect ratio, and installation orientation on condensation heat transfer, while the influence on pressure drop has not been taken into account in the present study. The results indicate that the condensation heat transfer coefficient in the tube increases as the inner diameter of the circular tube decreases. The condensation heat transfer coefficient increases by 1.086 times when the circular tube inner diameter is reduced from 10.7 mm to 5 mm. Under identical operating conditions, the condensation heat transfer coefficient of the mixed refrigerant in elliptical tubes increases with an increase in the aspect ratio. The average condensation heat transfer coefficient increases by 18.21% as the aspect ratio of the elliptical tube increases from 1 to 2. Compared to a vertical elliptical tube, a horizontal elliptical tube is more favorable for condensation heat transfer within the tube.