Background <p>Cesarean sections (CS), although commonly performed and generally considered safe, may be associated with prolonged hospitalization, increased postoperative pain, and a higher risk of complications. Accordingly, this study aimed to evaluate the effectiveness of a nurse-led Enhanced Recovery Program (ERP) on selected outcomes among women undergoing elective CS.</p> Methods <p>A quasi-experimental study was conducted across inpatient and outpatient settings at Cairo University Obstetrics and Gynecology Hospital, including 90 women allocated into a study group (<i>n</i> = 45) and a control group (<i>n</i> = 45). Data was collected using structured interviews, numerical pain rating scale, postoperative recovery criteria, functional outcome assessment, and satisfaction questionnaire.</p> Results <p>Both groups had comparable demographic characteristics. The ERP group demonstrated significantly better outcomes including reduced pain scores (2.71 vs. 4.26 at discharge, <i>p</i> &lt; 0.001), faster ambulation (4.37 vs. 8.11&#xa0;h), shorter hospital stays (9.22 vs. 11.88&#xa0;h), and zero wound infections compared to 13.3% in controls. The intervention group showed higher satisfaction rates (33.3% vs. 8.9% completely satisfied) and greater functional outcomes in physical activities, self-care, and baby care 48&#xa0;h post-discharge (<i>p</i> &lt; 0.0001).</p> Conclusion <p>The nurse-led ERP effectively improved post-cesarean outcomes, including pain control, recovery time, functional independence, and maternal satisfaction with self and infant care. The findings support integrating nurse-led ERP into cesarean section protocols across maternity hospitals to enhance maternal and neonatal outcomes.</p> Clinical trial number <p>Not applicable.</p>