Aim: This study aimed to evaluate the effect of improving nurses` awareness and selfefficacy to control extremities muscles contracture in critically head injured patients. Subjects and Method : A quasi-experimental design was utilized for the conduction of this study in the Surgical Hospital affiliated to Ain Shams University in the following Critical Care Units (Neuro-Surgery , ICU and Emergency ). Sample: A purposive sample was composed of 50 nurses with different ages, education and experiences. In addition, 40 critically head injured patients from the above mentioned settings. Tools of data collection : 1) Self administered questionnaire (pre / post tests ) to assess the studied nurses` knowledge as regards controlling extremities muscles contracture . 2) An observation checklist (pre / post tests) to evaluate studied nurses ' practices in relation to care of patient's withcritically head injury to control extremitiesmuscle contracture. 3) General self-efficacy scale (pre / post tests) to assess studied nurses` selfefficacy level. 4) Patients` condition assessment sheet (pre / posttests): a) Glasgow Coma Scale to assess level of consciousness . b) Muscle contracture assessment sheet. Results: Mean ages of studied nurses were (16.7± 9.6). More than half of them had diploma nursing with less than five years of experience. In addition, there were unsatisfactory level of nurses ` knowledge, practices and selfefficacy in pre test . As regards the studied patients , significant improvement was indicated in post and follow-up tests for muscle contracture . Conclusion : In light of the present study, improving nurses` awareness ( knowledge and practices ) and selfefficacy through educational guidelines was helpful on controlling extremities muscles contracture in critically head injured patients , whereas significant improvement was indicated in post tests compared to pre. Moreover, patients` health condition assessment (incidence of extremities muscles contracture) was reduced in post -tests. Recommendations: Further studies should be carried out on a large number of critical care nurses with evidence of results and generalization.