Background: Post gastric sleeve surgery, the changes in gastrointestinal physiology result in altered absorption and nutrient deficiencies. These patients need specialized nursing guidance to prevent unnecessary gastrointestinal symptoms. Aim: The study aims to examine the effect of hybrid nursing guidance on eating patterns and perception among patients post gastric sleeve. Design: quasi experimental (per-posttest) research design. Sample: A convenient sample of Eighty adult male and female patients. The sample was divided into two groups (study group 50 patients) and (control group 30 patients) undergoing gastric sleeve surgery Setting: Department of plastic surgery, gastric sleeve surgery unit and obesity outpatient clinic at Assiut university hospital. Tools: The data were collected by using three tools: (1) An interview questionnaire sheet (2) three-factor eating questionnaire and (3) Body image perception questionnaire. Results: there was a statistically significant difference in knowledge scores between study and control groups between the pre and posttest after 6th months from the application of the hybrid nursing guidance, as well as patients' eating practice pattern wear enhanced significantly post application of the hybrid nursing guidance, also patients complications post gastric sleeve were improved, finally patient‘ perception was significantly higher comparing to pre application values with (p = 0.001). Conclusion: This study showed that implementation of hybrid nursing guidance contributed positively with the changes of the patients post gastric sleeve surgery regarding eating practice pattern, prevent unnecessary gastrointestinal complications, and higher perception comparing to pre application of the hybrid nursing discharge guidance. Recommendation: Nurses should apply these guidelines as hospital routine care in the study place, as it will help patients adapt to their situation and increase their wellbeing as the initial aim.