Background: Now a day surgical treatments are common to alleviate some disease. Specially orthopedic surgery require special nursing care, due to immobilization and also patients are facing the problem of sleeplessness. So the researcher decided to assess the effectiveness of back massage on sleep among patients with major orthopedic surgery. Objectives: To assess the effectiveness of back massage on sleep among patients with major orthopedic surgery. Design: Quazi experimental design where pre and post test with control group. Setting: Krishna Kumar Orthopedic Hospital, Nagercoil, Tamil Nadu. Participants: Thirty patients with major orthopedic surgery, fulfilling the inclusion criteria were selected by purposive sampling technique. Methods: 15patients were control group and 15patients were experimental group. Only the experimental group patients received back massage. Pre and post test assessment done with Subjective assessment of quality of sleep scale for both groups. Results: From the findings of the study it can be concluded that the highest percentage of patients were in the age group above 50 years, most of the patients were males, majority of the patients had undergone open reduction and internal fixation and most of them had no previous history of any surgery. The area wise comparison between control and experimental post test mean percentage difference was 18%. Paired ‘t’ test score was 15.48 for experimental group at the level of significant (P) = 0.05. Moderately significant difference was found between control and experimental group post test scores of patients in the areas of sleep. Unpaired ‘t’ test score was 3.05 at the level of significant (P) = 0.05. No significant association between sleep among control and experimental group of patients with their demographic variables, i.e. age, sex, type of surgery and previous history of surgery Conclusion: Application of back massage on patients with major orthopaedic surgery enhances the level of sleep. Therefore, back massage can be used as a safe and effective tool to help to improve the sleep.