Background: Head trauma is an important exporter of morbidity and mortality worldwide, with approximately 69 million affected individuals each year. The golden hour is period of time lasting for one hour or less following a traumatic injury during which there is argent need for prompting care of the patients to improve outcome and prevent death. The nurses’ performance playing a vital role in reducing the morbidity and mortality of patients with head trauma. This study aimed to assess the level of nurses’ performance regarding patients with head trauma during golden hour at emergency department in Zagazig University hospitals. Research design: A descriptive exploratory design was utilized to achieve the aim of this study. Setting: The study was conducted in ED at the emergency hospital, Zagazig University Hospitals. Sample: a convenience sample of all available nurses working in ED. Tools of data collection: Self-administered questionnaire, observational checklists, and nurses’ attitude assessment likert type rating scale were used. The study finding revealed that, about 85.7 % of the studied nurses had unsatisfactory level of knowledge, while about 77.1% of the studied nurses had incompetent level of practices, also 91.4% of the studied nurses had negative attitude regarding patients with head trauma during a golden hour. Conclusion: It can be concluded that the studied nurses need special educational guidlines to improve nurses’ performance regarding patients with head trauma during a golden hour. It is recommended to continuous in-service training programs for the purpose of refreshing, updating the nurse’s knowledge and practice regarding patients with head trauma during golden hour.