Background: Patient safety is of great concern to healthcare leaders and is a top priority in all healthcare organizations. It is essential to promote an organizational commitment that values a culture of safety through reporting of medical error and analysis of untoward events. Nursing peer review facilitates the establishment of a culture of safety, as it seeks to analyze medical errors and eliminate the reoccurrence of untoward events.Aim: To develop nursing peer review protocol for patient safety.Method: This study is a quasi-experimental study.The study subjects consisted of three groups: staff nurses (316), head nurses plus nursing directors (37) and (40) as jury group. The study was conducted in Military Production hospital and Nasr City Insurance hospital. Four tools were used for collecting data (two self administered questionnaires format and two opinionnaires format).Results: There was no statistical significant difference in both of the studied hospitals regarding all patient safety dimensions. There was poor safety organizational culture regarding all mentioned dimensions. There was no patient safety committee in both hospitals.Conclusion- Nursing peer review protocol for patient safety was developed and validated.