Background: Maintaining stability of external fixation is an important part in nursing management by creating plans that teach patients about care of ilizarov ring fixation devices. Aim: Assess the effect of nursing intervention protocol on outcomes of patients undergoing Ilizarov external ring fixation. Design: A quasi experimental design was used Sample: 60 adult patients were randomly assigned into 2 equal groups for a purposive study. Setting: The study conducted in the Trauma& Orthopedic Department at the Assiut University Hospital and the affiliation clinic. Tools: I: Patient's assessment sheet, II: Patients' Stirling's Pressure Ulcer Severity Scale, III: Checketts & Otterburn's Grading System and IV: Kurz normal ranges of joint motion scale. Results: A statistically significant differences between study and control groups related to infection grading, ROM, wound care post implementation of the nursing intervention protocol. Conclusion: The nursing intervention protocol has a positive effect on patient outcomes in relation to promoting the wound healing and reducing pin site infection, improving joint function and preventing pressure ulcer. Recommendations: The nursing intervention protocol should serve as the basis for routine nursing care for patients with external fixators to improve their outcomes.