Background: Egypt showed that head and neck cancers make up about 17-20% of adults must managed by tracheotomies for the following reasons bronchial toilet, prolonged mechanical ventilation, occlusion of the upper airway, airway protection or maintenance and easier weaning. Aim: This study aimed to evaluate the effect of implementing educational programs on self-efficacy and late pulmonary complications among patients with permanent tracheostomy. Design: A quasi-experimental research design (pre- posttest and follow up) was used. Sample: 60 adult patients with permanent tracheotomy were selected for a purposive study. Setting: The study conducted in surgical outpatient clinic at Qena Tumor Hospital. Tools I: Structured Interviewing Questionnaire consists of two parts II: Self-Care Reported Practice III: Tracheostomy Self-Efficacy Scale and IV: Pulmonary Complications Assessment Scale. Results: There were statistically significant differences between pre/post and pre/follow-up as regard total mean knowledge scores , mean care practice score, self–efficacy level mean scores and late Pulmonary complication severity related post implementing educational program. Conclusion: The educational program is effective in enhancing patients' knowledge, self-efficacy and decreasing late pulmonary complications in patient with permanent tracheostomy. Recommendations: Increase patient's awareness of the complications associated with tracheostomy and self-care practice.