Background: Tele-nursing Instructions are essential for the management of heart failure disease. Aim: Evaluate the effect of tele-nursing instructions and follow up on self-care and health status of patients with heart failure. The design used in the study was quasi-experimental. The study was conducted in cardiology department at Assiut University Heart Hospital. Sample: 60 adult patients were male and female, purposively sampled split into study and control groups. Tools: Tool (I): Structured interview questionnaire Tool (II): "Dutch heart failure knowledge scale". Tool (III): "Heart failure self-care behavior scale". (VI): Cardiomyopathy questionnaire. Results: The present study revealed that (96.7%) of study group had high level of knowledge, (90.0%) had adequate self-care level, and (76.7%) with good health status after applying telenursing instructions. There were statistically significant differences among the study group before and after applying telenursing instructions at p. value (<0.05). Conclusion: Heart failure patients' knowledge level, self-care, and health status significantly improved after applying telenursing instructions. Recommendation: Enhance telenursing use in nursing practices and use it in conjunction with follow up phone to increase patients' compliance with therapeutic plans.