Background: Ilizarov has been the gold standard for treating many types of fractures and bone deformities. The patient with Ilizarov has restricted activity in daily living and poor self-care practices that need to be improved. Patient education is essential aspect that helps in acquiring knowledge, self-care practice and enhancing physical activity Aim: Evaluate effect of Ilizarov nursing care guidelines on patients' knowledge and self-care practices. Design: In this study, a quasi-experimental design was used. Setting: Orthopedic inpatient units at main Mansoura University Hospital. Subject: A purposive sample of 40 patients was divided into two equal groups: control and study groups. Tools: (I): Structured interview questionnaire for Ilizarov patients. Tool (II) Ilizarov self-care practice. Results: The study and control group 80%, 85% respectively had unsatisfactory level of knowledge pre implementation of guidelines while70%, 35% of study and control group respectively had higher level of knowledge post guidelines implementation .Also there was an improvement in study group self-care practice level in post and follow up after guidelines implementation with statistically significant differences between both groups. Additionally there were a highly statistically significant difference between study and control group regarding lower extremity functional scale and modified barthel index with (p<0.001) and (p<0.005 - 0,035) respectively post and follow up guidelines implementation. Conclusion: patients' knowledge and self-care practice improved after the Ilizarov guidelines implementation at post and follow-up with highly statistically significant results. Recommendations: A standardized colored booklet about Ilizarov patient self-care guidelines should be available.