Abstract Background: Nurse can play an important role in helping reduce costs based on the unit census and patient acuity. Actually when nursing hours exceed the needed hours by patients, nurse managers typically are required to submit a report explaining the reason. Nurses can help make a difference in their unit budgets by not overstaffing their unit, avoiding excessive use of unscheduled leave and monitoring the use of supplies. Aim of Study: To explore the impact of average nursing care hours on hospital cost and patient satisfaction in Emer-gency Department. Material and Methods: Design: Descriptive, exploratory, correlational design was utilized to carry out the study. Setting: The study was conducted in Emergency Depart-ment at Soud Kafafi University Hospital. Sample: Convenient sample included twenty-five nursing staff worked in Emergency Department and random sample of Emergency Department conscious patients, the number of study sample was one thousand patients. Tools: Four tools were utilized for data collection, the first tool was patients triage level assessment; the second was financial record sheet, the third Nursing Care Hours Cost and the fourth was patient satisfaction questionnaire. Results: The study findings revealed that there was highly significant statistical strong positive effect between nursing care hours and hospital cost (Adj R2=.925, B=.385, p=.000). While, there is no statistical significant correlation between nursing care hours with patient satisfaction. Conclusion: The study concluded that positive effect between nursing care hours and hospital cost while no statistics effect was found between nursing care hours and patient satisfaction. Also, patients with highly acuity level consuming high nursing care hours and hospital cost. Recommendations: It is recommended that the head nurse should measure nurses direct care hours costs per patient in order to find out patient level nursing costs/intensity, the study recommend to develop strategies to measure nursing at nurse-patient encounter for developing nursing business intelligence by optimizing care vs costs and matching right nurse care provider.