Background: Botox is a new form of treatment for over active bladder syndrome and is administered via cystoscopic injections of the bladder wall. Aim: To evaluate the effect of nursing instructions on outcomes of patients with overactive bladder syndrome undergoing intravesical botox injection. Research design: Quasiexperimental design was utilized.Setting the study was conducted in the urology departments at Assiut Urology University Hospital. Sample: Purposive sample of thirty patients undergoing intravesical botox injection. This sample was divided into study and control groups (15 patients for each). Tools: tool (I): Patient structured interview questionnaire sheet. Tool (II): Numeric scale for pain .Results: there was significant difference between study and control group after application of nursing instructions regarding total knowledge .In study group one fifth of patients had recurrence of urinary incontinence post application of nursing instructions while in control group more than half (60%). the mean score of numeric scale for assessment of pain was 1.2±0.68 in study group while in control group was 3.4±1.76 post instructions. Conclusion: Nursing instructions are effective in improves patient's outcomes for the study sample. Recommendations: Kegel exercises can be adapted as therapeutic behavioral methods for care of patients with overactive bladder syndrome for patients undergoing intravesical botox injection