Background: Emergency hypertension is elevation of blood pressure (Systolic over 180 or diastolic over 120) associated with acute end organ damage .The critical care nurse assumes important role for the care and clinical stabilization of the patient with emergency hypertension Aim this study was carried out to evaluate the effect of nursing guideline on patient's outcomes with hypertension emergency. Setting This study was conducted at coronary care unit. Subjects A convenient sample of (60) patients that divided in to two groups (control 30 and study 30) collected over threeteen months. Tools Two tools were utilized to collect data pertinent to study Tool I Socio demographic and clinical data assessment sheet. Tool II Sequential Organ Failure Assessment scale "SOFA" score. Nursing guideline for patient with emergency hypertension Methods emergency hypertensive nursing guideline implemented by researcher using Tools I, II from the first day of admission and until discharge then the data were recorded in the developed tools. Results As regards to the emergency hypertensive patients suffering neurological manifestations, results revealed that there were statistically significant difference between studied groups in first day (P=0.046). As regards to the emergency hypertensive patients suffering renal manifestations, results revealed that there were statistically significant difference between studied groups in third and fourth day (P=0.048 and P=0.019) respectively. Conclusion Applying nursing care guideline for patients with emergency hypertension showed statistically significance difference in reduction incidence of complication regarding kidney function in third and fourth day and length of hospital stay.