Background Previous studies conducted on nurses’ knowledge regarding endotracheal tube cuff pressure revealed that there were differences in intensive care nurses’ knowledge, leading to varying practices. This study aimed to evaluate the effect of an educational intervention based on existing evidence-based guidelines, on the knowledge of nurses regarding managing endotracheal tube cuff pressures in Malawian intensive care units.Methods The study followed a quasi-experimental approach, with a pre- and post-test design using an educational intervention. Intensive care unit nurses were randomly assigned to two intervention groups. Both groups received a half-day educational session, a printed version of the evidence-based guidelines, a printed and laminated summary of the guidelines and a related algorithm. Additionally, Group 2 received four monitoring visits. Pre-and post-test questionnaires were conducted between February and August 2016. Descriptive and inferential data analysis (a chi-square test and t-test) were utilised.Results Knowledge on the nursing care practices for the management of endotracheal tube cuff pressure was improved for both groups following the educational intervention, although only the results comparing the Intervention 2 group participants’ indicate that the level of knowledge were significant (t(d.f.=48)=2.08, p=0.043, d=0.59).Conclusions The implementation of a formal training programme and mentorship programme for nurses working in the intensive care unit in Malawi would be of great benefit to equip nurses with adequate knowledge and skills for managing endotracheal tube cuff pressure. Follow-up studies would also assist in understanding how the implementation of guidelines could be done most effectively to achieve better knowledge outcomes among nurses concerning nursing care practices in this context.