Introduction <p>Altruism, the desire to help others, is a common motivation for choosing a career in nursing. Improved understanding of the role of altruism as a reward or motivation for currently-practicing nurses may inform future interventions to improve effort-reward balance among practicing nurses. Therefore, the purpose of this study was to collect, examine, and present literature on how altruism has been described as a reward mechanism or motivation for engaging in professional nursing.</p> Methods <p>This scoping review of literature used the Arksey &amp; O’Malley method, PRISMA-ScR reporting checklist, and Rayyan review management platform. PubMed, Web of Science, and CINAHL were searched for: “nurs* AND ((reward OR compensation OR motivation) AND qualitative).” Inclusion criteria included peer-reviewed empiric study in English, pertaining to nurses employed in a patient-facing role, and pertaining to altruism or a similar concept (e.g., benevolence, helping others) as a reward, motivator, or compensation mechanism for professional nursing work. No date limitations were imposed.</p> Findings <p>Thirty-nine studies met search criteria. Three themes were identified: (1) work engagement (<i>n</i> = 30), e.g. personal connectedness with their work through altruism (2), barriers to altruism, self-sacrifice (<i>n</i> = 15), e.g. lack of resources in the workplace and (3) spirituality (<i>n</i> = 15). Nurses described engagement with their work through altruism. Barriers to altruism were described, particularly due to lack of resources in the workplace, and some nurses engaged in self-sacrificing behaviors to compensate for unmet needs. Many nurses described spiritual fulfillment and nursing as a religious practice through altruism.</p> Conclusions <p>Work engagement and spiritual fulfillment through altruism is described as a reward or motivation by nurses. However, barriers to altruism and self-sacrifice to overcome barriers were described.</p>