Objective To investigate the initiation and sustenance intention of the head-of-bed elevation behavior among nurses in neurological intensive care unit （NICU）, so as to provide reference for developing clinical behavioral intervention path. Methods A total of 716 NICU nurses from 11 3A general hospitals in Chongqing were recruited by convenient sampling method, then they were investigated using a self-made questionnaire of the initiation and sustenance intention on the head-of-bed elevation behavior and the general information questionnaire. Results In the past six months, 14.11% NICU nurses could comply with the guidelines for head-of-bed elevation, 41.76% NICU nurses didn′t participate in postural management related education or training for neurological critical patients. The score of initiation intention on the head-of-bed elevation behavior among NICU nurses was 31.00±9.26, and the subscale score rate of participatory dialogue, behavioral confidence and changes in the physical environment was 43.05%, 68.20% and 72.75%. The score of sustenance intention on the head-of-bed elevation behavior among NICU nurses was 26.19±6.54, and the subscale score rate of emotional transformation, practice for change and changes in the social environment was 72.83%, 72.58% and 72.92% respectively. Conclusion The cognition and self-assessed compliance with the head-of-bed elevation behavior among NICU nurses are not good, so nursing managers should strengthen their cognition of the behavior change process, identify the factors influencing the nurses′ head-of-bed elevation behavior initiation and sustenance process, and establish targeted behavior intervention path, so as to improve NICU nurses′ postural management level.