A pacemaker is an important to save lives and avoid death for patient with some cardiac disease. Only patients who receive sufficient nursing care and support in adhering to a permanent pacemaker will experience the best results following pacemaker insertion. Aim: assess the quality of life of patients using the pacemaker in Zagazig University Hospitals through assessing patients' knowledge about using pacemaker, determine the patient reported practice and evaluating quality of life for patient with using pacemaker. Design: descriptive research design was utilized in this study. Sample: Purposive sample of 120 patients was used in this study. Setting: this study was conducted in outpatient cardiac clinics at Zagazig University Hospitals. Tools: A structured an interview questionnaire include 5 parts :part1-Demographic details on patients who use pacemaker. part2-past and present medical history. part3- patients knowledge about pacemaker.part4-patient reported practice regarding with using pacemaker. part5- quality of life assessment questionnaire for patient with pacemaker . Results 61.7% of the studied patients had unsatisfactory knowledge regarding pacemaker, 68.3% of the studied patients had inadequate reported practices level regarding pacemaker and 42.5% of the studied patients had low quality of life level, and 31.7% of them had moderate level, while 25.8% of them had high quality of life level .Conclusion. There were highly statistically significant correlation between total studied patients knowledge, reported practices and quality of life Recommendation Nurses should attend updated conferences and in service training programs/or workshops about post permanent pacemaker implantation instructions to provide adequate health education to their patients