Background: Patients with head and neck cancer are in danger of creating carotid artery rupture that may cause lifethreatening problems and death Aim: to assess the nursing performance regarding immediate management of carotid artery rupture. Study design: A descriptive research design was utilized in this study. Setting: The study was conducted in the critical care unit at south Egypt cancer institute at Assiut University hospital. Sample: A convenience sample of all available nurses (forty nurses) Tools: two tools were used for data collection, Nurses' knowledge assessment and observational checklist. Results: The majority of studied nurses (80%) were having an unsatisfactory level of knowledge regarding carotid artery rupture. Conclusion: Nurses` knowledge regarding carotid artery rupture and practice regarding immediate care of carotid artery rupture in critical care unit at south Egypt cancer institute at Assiut University hospital is unsatisfactory and have an inadequate level of knowledge and practice. Recommendation: Nurses need for in-service training programs to improve their knowledge and practice regarding the management of carotid artery rupture.