Background: Immobilized patients are vulnerable to pressure ulcer development due to severity of illness, increased length of stay, poor tissue perfusion due to hemodynamic instability, immobility, and poor nutritional status Pressures sores are areas of localized damage to the skin and underlying tissue friction. This type of damage can also be known as pressure ulcers, bedsores, or decubitus ulcers. Aim: Evaluate the effect of safety Skin protocol on pressure ulcer occurrence among immobilized patients. Subjects and method: Design: A quasi-experimental research design was utilized. Subjects: convenience sample  of 70 adult patient, assigned into two groups (study and control) each group consisted of 35 patients. Setting: The study was conducted in the Mansoura University Hospital at Neurological departments and Neurological ICU. Tools: Two tools were utilized tool one pressure ulcer status, tool 2 skin safety observational chick list, and it was done at the time of admission until six days. Results: data revealed that 70% of patients maintained their skin integrity all over the study period, 30% develop the first stage of the ulcer.The effect of safety skin protocol was significant statistically. Conclusion: Immobility, increase pressure, Immobilized patients more susceptible to pressure ulcers Recommendations: It is important to enhance the awareness level among the public, patients, and also the health care providers regarding the importance of applying safety skin protocol for immobilized patients from admission regular educational programs to continuously update the nurse's knowledge with the advanced and effective practice of skin care and early detection of pressure ulcers.