Background: Cardiac surgery is a specialized area concerning the surgical treatment related to the heart and thoracic aorta. Chest tube removal is described as one of the worst memories that the patients experience during the perioperative period. Aim of the study: To assess severity of pain and anxiety before chest tube removal among cardiac surgeries patients. Design: Descriptive research design was used to conduct this study. Sample: A purposive sample of 60 adult patients from both genders who were randomly and alternatively. Setting: The study was conducted in the cardio-thoracic intensive care unit at Fayoum University Hospitals. Tools: Four tools were used for data collection, (I) Structured Interviewing Questionnaire, (II) The Numerical Pain Rating Scale and (III) Hamilton Anxiety Scale. Results: This study represented that high percentage of severe pain and anxiety for study and control groups before chest tube removal. Conclusion: It can be concluded that, cardiac surgeries patients suffered from severe pain and anxiety before chest tube removal. Recommendations: Design nursing intervention program related to chest tube removal for each patient undergoing cardiac surgery.