Objective To investigate the attitude toward and willingness to nurse practitioner (NP) among nursing managers in Hunan province. Methods A self-designed questionnaire was used to survey nursing managers from 14 cities and states of Hunan pro-vince. Results Among 4,998 nursing managers, 34.91% and 59.84% believed that it was very necessary or necessary to conduct NP programs, and 79.49% thought that NP had a bright future of employment. Multiple linear regression showed that professio-nal title, education background, whether or not they run a nurse-led clinic, and whether or not they have experience of NP practice or research were the factors influencing attitude toward and willingness to NP of nursing managers (P＜0.05 for all).Nursing managers thought that the main influencing factor of NP was the nation′s policy orientation (45.10%) and they were also worried about poor understanding and acceptance by the patient (60.20%). Conclusion Nursing managers in Hunan province generally hold a positive attitude towards NP and have a strong desire for developing, but they still have concerns about it.Based on the national conditions, we need to actively involve NP in health care services, thus promote national health level.