This article illustrates a comprehensive review, synthesis, and critical appraisal of the research evidence surrounding guided imagery utilization in cardiac surgery. By adding guided imagery in the “usual care” of adult cardiac surgery patients, pre- and postoperative anxiety and pain, as well as hospital length of stay may be reduced. However, in spite of fairly strong “level” of evidence, the limited number of studies and low research quality deter the full acceptance of guided imagery as a standard therapeutic modality in this population. Acute and critical care nurses can offer guided imagery to their patients based on the documented safety of its use and clinically significant findings that it may have a direct impact on patients’ recovery outcomes. Higher quality, methodologically rigorous, and larger-scale studies are warranted to establish the efficacy and standard utilization of guided imagery during perioperative and rehabilitative periods. Future studies should also address long-term outcomes, specifically on physical and psychological health, well-being, and overall quality of life after cardiac surgery.