Objective To explore nurses′ decisionmaking process in physical restraint use for ICU patients. Methods Indepth semistructured interviews were conducted on 12 ICU nurses, then data were transcribed and analyzed to identify themes. Results Eleven categories reflecting decisionmaking process in physical restraint use were identified, including 6 decisionmaking stages of risk prediction, alternative selection, physical restraint intention, implementation, reflection and rationalization, 4 influencing factors of patients, nurses, family members and management, and 1 outcome objective of safety. Conclusion Nurses′decisionmaking in physical restraint use is complicated and affected by multiple factors. The study results provide references for targeted intervention and management.