Introduction <p>The competency of nursing students in ensuring child patient safety is crucial in the healthcare landscape, particularly with the increasing emphasis on patient-centred care and safety within clinical settings. This study aims to determine the self-evaluation levels of paediatric patient safety competence among nursing students.</p> Methods <p>This study is a descriptive cross-sectional study. The setting of the study was Faculty of Health Sciences at the Public University located at southeastern of Turkey. The population of the study consists of 3rd and 4th-year nursing students at Faculty of Health Sciences (<i>N</i> = 190). A total of 162 nursing students participated in this study. Convenience sampling was used to recruit participants. Data were collected between May 12, 2025 and May 30, 2025. The data were collected by using questionnaire technique with a data collection form consisting of 3 parts: (1) demographic characteristic form, (2) Patient Safety Competency Self-Evaluation Tool, and (3) Competency Scale for Pediatric Nursing for Nursing Students. The data analysis was conducted using IBM SPSS.</p> Results <p>Nursing students generally have a moderate to high level of competence regarding patient safety, but they need development in certain areas such as safe medication administration. Clinical experience with paediatric patients was significantly associated with higher competency scores across all domains (<i>p</i> &lt; .05). Additionally, the significantly higher patient safety and paediatric nursing competency scores of students with clinical experience highlight the importance of practical training. Receiving formal training on child health showed no significant impact on competency levels (<i>p</i> &gt; .05). The majority of students (93.2%) reported a strong desire for additional training, particularly in safe medication administration, which was identified as their greatest area of concern.</p> Conclusion <p>This study revealed that nursing students generally have a moderate to high level of competence regarding patient safety, but they need development in certain areas such as safe medication administration. Additionally, the significantly higher patient safety and paediatric nursing competency scores of students with clinical experience highlight the importance of practical training. Vast majority of nursing students requested additional training on paediatric patient safety. Recommendations include enhancing simulation-based learning, integrating mentorship programs, and expanding paediatric-specific modules in nursing curricula to better prepare students for safe and effective paediatric care.</p> Clinical trial number <p>Not applicable.</p>