Introduction Colostomy is a surgical procedure that creates an abdominal opening in which a part of the colon is transferred outside the abdominal wall to form a stoma in which digested foods passes into an external pouching system, and can be temporary or permanent . Stoma affects every aspect of patient’s lives. Patients with colostomy may encounter changes in their daily life, particularly in their social network and in their sexuality, triggering feelings of insecure and fear of rejection. Self-efficacy plays a significant part in the development of stoma adjustment. The surgical nurses play a vital role in the care of colostomy patients to assist them adjust to the life rapidly after surgery Aim of the study This study aimed to evaluate the effect of educational program on self-efficacy and peristomal skin complications for patients with permanent colostomy. Study hypothesis: 1. Patients knowledge and practice score could be improved post implementing the educational program compared to pre implementing educational program. 2. Patients self-efficacy score could be improved post implementing the educational program compared to pre implementing educational program. 3. Patients peristomal skin complications could be reduce post implementing the educational program compared to pre implementing educational program. Methods: Study design: A quasi- experimental, (pre and post) study design was used. Setting: The study was conducted in the surgical outpatient clinic at Zagazig University Hospital. Zagazig, Egypt. Subjects: A purposive sample of 60 patients with permanent colostomies. The patients were selected according to the following inclusion criteria: Adult patients between 18 and 60 years of both sexes who are able to communicate and agreed to take part in this study. Results: - Regarding the causes of the colostomy, 65.0% of patients had colorectal cancer. - the total satisfactory knowledge increased from 8.3. % in the pretest to 93.3% and 90.0% immediately post and post three months, - There were statistical significant difference regarding skin complication between pre, post one and post 3 months at p<0.001. - there was positive correlation between knowledge, practice and self-efficacy in the pre and post three months after implementing educational program. - there was negative correlation between knowledge, practices, self-efficacy and peristomal skin complication in the pre and post three months after implementing educational program. Conclusion: The educational program improved the knowledge, practices, and self-efficacy, moreover reduce the severity of the peristomal skin complication in colostomy patients. Recommendation: Colostomy patients should receive a planned educational program before their discharge.