Nephrostomy tube is inserted directly into the kidney's collecting system to allow permanent or temporary urinary drainage. Many complications may result either from insertion procedure or presence of catheter in the body. Aim of the study: To evaluate the effect of designated nursing guidelines on the incidence of complications for patients undergoing percutaneous nephrostomy tube. Research design: A quasi experimental design. Setting: Urology surgery department and urology outpatient clinic in Fayoum University Hospital. Methods: A purposive sample of 60 adult patients, recruited randomly into two equal groups (30 patients in each). Tools: Included, Structured Interview questionnaire, patients knowledge assessment questionnaire, patients practice observational checklist, percutaneous nephrostomy tube complications observational checklist. Results: There was a statistical significant difference between both groups as regarding knowledge, self-care practices (P-value <0.001), incidence of complications post implementation of nursing guidelines with higher percentage of complications among control group. Conclusion: Application of the guidelines had a positive effect on the outcomes of patients undergoing percutaneous nephrostomy tube. Recommendations: Nurses should apply the educational instrument that would help patients improve their self-care practices to reach positive outcomes.