Nasri confirmed via social media on Thursday he will be out of action for a further three months due to the injury, which has sidelined the France international since October 17.
But the 28-year-old is now facing a five month lay-off after suffering a setback in training.
"We don't have Samir Nasri for four or five months," Pellegrini said.
"He has a tendon injury in his right leg so now he must have surgery because it's an important [serious] injury."
Nasri has made seven appearances this season for City, who top the Premier League standings on goal difference after 12 matches.
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