Background: External fixators are golden method in controlling fractures however, a key drawback to its use is high incidence of pin-tract infection, pain, disability and decrease quality of life. Aim of the study: was to evaluate the effect of safety measures precautions on pain and quality of life among orthopedic patients with external fixation Subjects and Methods: Research Design: A quasi experimental design was utilized in this study. Setting: The study was conducted at orthopedic departments at Accidents hospital and Outpatient hospital at Zagazig University Hospitals. Subjects: Purposive sample of 40 orthopedic patients with external fixation divided into two groups each group consisted of 40 patients. Tools of data collection: Three tools were utilized for data collection patients' interviewing questionnaire, Safety measures precautions, quality of life questionnaire. Results: revealed that more than half of patients aged below 30 years, more than three quarter were male, there was increase in patients’ total knowledge, self-care practice, total safety measures, there was decrease in pain level, and improve quality of life post intervention and in follow up compared to pre intervention. There was a statistically highly significant difference in relation between high quality of life and academic qualification, there were negative correlations between pain with each of (knowledge, self-care practice, safety measures and total quality of life). Conclusion: safety measures precautions significantly improved patients’ knowledge, practice, pain, and quality of life, pain has a statistically highly significant effect on quality of life. Recommendations: safety measures should be included in routine nursing care and patient education.