Objective To investigate the level of nursing clinical judgment among nurses and the influencing factors, and to provide a reference for improving nurses′ clinical judgment.Methods A convenience sampling method was used to select 383 nurses from 2 tertiary hospitals in Wuhan as participants from December to October 2024.Instruments included a demographic questionnaire, the Nursing Clinical Judgment Scale （NCJS）, the Critical Thinking Disposition Inventory （CTDI）, and the Nurse Clinical Reasoning Scale.Results The mean score for nursing clinical judgment was (100.48±13.18) points, indicating a relatively high level.Multivariate stepwise linear regression identified age, job satisfaction, and clinical reasoning ability as significant predictors of nurses′ cli-nical judgment (all P＜0.05).Conclusion Although nurses in tertiary hospitals demonstrate relatively high nursing clinical judgment, there remains room for improvement.Nursing managers should strengthen targeted training, implement "experienced nurse mentoring new nurse" programs to cultivate clinical judgment in less experienced nurses, and take measures to improve job satisfaction and clinical reasoning ability to promote development of clinical judgment.