Background: Bone marrow biopsy plays a critical role in the identification and management of several hematological and systemic illnesses. Even although the procedure has been conceded for years, it remains uncomfortable and extremely painful experience for all patients. While applying evidence-based guidelines in dealing with a patient undergoing bone marrow biopsy is not only an absolute duty for nurses practicing, however, is too a central role to the nursing science. Objectives: This study aims to assess and evaluate the impact of evidence-based guidelines on performance, perception, and satisfaction of patients undergoing bone marrow biopsy Method: Quasi-experimental research design was conducted. The purposive sample for all patients (50) admitted for Bone Marrow biopsy with various hematological disorders at Damietta Oncology Institute. The instrument was used to collect study data include patient socio-demographic, health information characteristics, patient's performance, the perception of patient's and satisfaction. Result: It showed that the majority of patients had a higher total mean score at post-evidence-based guidelines implementation than pre implementing of guidelines regarding patient's perception, performance, and satisfaction with statistically significant difference (p ≤ 0.05).Conclusion: Evidence-based guidelines improve patient's perception, performance, and satisfaction regarding bone marrow biopsy. Recommendations: Activate implementation of bone marrow biopsy an aspiration guidelines manual in the hospitals and it's availability to all patients in the simple media and language. Also, nurses must be trained to implement evidence-based guidelines. This study may deliver a performance framework for the future advance in other nursing evidence-based practice.