Background <p>Maggot debridement therapy (MDT) is a biotherapeutic approach that uses sterile larvae to remove necrotic tissue and promote wound healing. Although its effectiveness in managing chronic wounds is well established, clinical adoption remains limited. Nurses are central to wound care, yet little is known about their MDT knowledge in Malaysia. This study assesses nurses’ knowledge of MDT and examined the influence of demographic, professional, and educational factors within a tertiary teaching hospital setting.</p> Methods <p>A cross-sectional study was conducted among 165 nurses selected through random sampling. Data were collected using a validated self-administered questionnaire assessing sociodemographic data, professional experience, and MDT knowledge. Descriptive statistics were used to summarize data, and Pearson chi square and Fisher’s Exact test were applied to determine associations between knowledge levels and key variables.</p> Results <p>The mean age of participants was 32.72 years. Of these, 41.8% had 6–10 years of experience, 89.7% held a nursing diploma, and 87.9% had heard of MDT. Only 26.1% demonstrated high knowledge, while 52.7% showed low knowledge. A significant association was found between knowledge level and having heard of MDT (<i>p</i> = 0.040) and having performed MDT (<i>p</i> = 0.025).</p> Conclusion <p>Nurses demonstrated limited knowledge and practical experience in Maggot Debridement Therapy despite general awareness of its clinical value. Knowledge was significantly associated with prior exposure and hands-on experience, underscoring the importance of experiential learning. Incorporating MDT into nursing curricula, continuous professional development, and institutional protocols is crucial to enhance evidence-based wound care and clinical adoption.</p>