Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)`s clinical practice guideline which is `Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.` There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses` performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.