Objective To explore the mediating effect of job esteem among operating room nurses between safety organizing and workplace deviance behavior, and to provide reference for nursing managers to take targeted measures to reduce their workplace deviance behavior. Methods A survey was conducted on 729 operating room nurses using the Evaluation Scale of Workplace Deviance Behavior of Nurses, the Safety Organizing Scale, and Job-Esteem Scale for Nurses in Hospital. Results The score of workplace deviance behavior among operating room nurses was (25.02±5.96) points. There was a negative correlation between job esteem, safety organizing, and workplace deviance behavior scores(all P<0.05). Job esteem played a partial mediating role between safety organizing and workplace deviance behavior, accounting for 58.54% of the total effect. Conclusion The higher the level of safety organizing, the less workplace deviance behavior of operating room nurses, and the job esteem plays a partial mediating role between the two variables. We should actively create a safety culture atmosphere, promote safe behaviors in the work of operating room nurses, and enhance their job esteem, in an effort to reduce workplace deviance behavior.