Introduction Cardiac pacemakers (PM) are an operative treatment for, atrioventricular block, sick sinus syndrome, and other severe cardiac dysrhythmias. The number of patients getting pacemaker implantation is steadily increasing as the population ages and cardiovascular disease becomes more common . Pacemaker is a small device that's placed under the skin in patient's chest to help in contrsregular heartbeat., Implanting a device is a life-changing experience for the person, both physically and psychologically., Patient education and support are essential for enhancing self-care abilities, improving outcomes and decreasing complications &unnecessary hospitalizations. Aim of the study This study aimed to determine effect of nursing protocol of care on health related outcomes for patients undergoing permanent pacemaker implant. Study hypothesis: - patients undergoing permanent pacemaker implant who receive nursing protocol of care will exhibit better health outcomes than who do not receive. Methods: Study design: A quasi- experimental, (pre and post) study design was utilized to conduct this study. Setting: The study was conducted at the Cardio- Electrophysiology Unit at the new Main University Hospital, Egypt. Subjects: A convenience sample of 100 adult patients with permanent cardiac pacemaker implantation aged from 20 up to 60 years old, both sexes (male & female) and agreed to take part in this study. Results: - Overall total scores of self-care practice and patients knowledge was improved significantly in the study group immediate post and post three months from program implementation in compared with the control group indicating a significant difference between the two groups after implementing a teaching program (P>0.001). Conclusion: The nursing protocol of care improved significantly in the study group immediately post and post three months from nursing protocol of care. Recommendation: training program for nurses about protocol of care for patients with permanent pacemaker. Future studies are needed about artificial pacemaker issues to develop evidence-based nursing management guidelines from different health centers in Egypt.