A fixed point index theory is developed for a class of nowhere normal-outward compact maps defined on a cone which do not necessarily take values in the cone. This class depends on the retractions on the cone and contains self-maps for any retractions, and weakly inward maps and generalized inward maps when the retraction is a continuous metric projection. The new index coincides with the previous fixed point index theories for compact self-maps and generalized inward compact maps. New fixed point theorems are obtained for nowhere normal-outward compact maps and applied to treat some abstract boundary value problems and Sturm-Liouville boundary value problems with nonlinearities changing signs.