Objective <p>The aim of this study was to examine the relationship between altruism levels of first-year nursing students and the factors influencing nursing career choice.</p> Background <p>Career choice is an important decision that influences an individual’s lifestyle, social status and sense of purpose. In health professions, this choice is often shaped by both intrinsic and extrinsic factors such as job security, family expectations and the desire to help others. Nursing, historically defined as an altruistic profession, continues to emphasize compassion and service to humanity. However, changing social and professional contexts may influence students’ motivations. Understanding how altruism relates to nursing career choice is therefore essential for strengthening professional identity and retention in the field.</p> Design <p>The study was conducted using a descriptive cross-sectional survey design.</p> Methods <p>Data were collected via an online survey that included a demographic information form, the Altruism Scale and the Nursing Career Choice Scale. Descriptive statistics and multiple linear regression analysis were used in the analysis. A total of 110 first-year nursing students studying at a state university during the 2024–2025 academic year who voluntarily agreed to participate were included in the study.</p> Results <p>The mean altruism score was located above the midpoint of the theoretical scale range. The highest-rated factors influencing nursing career choice were believing that there would be no unemployment in nursing, receiving positive feedback from others about being a good nurse, and the desire for self-expression. Multiple linear regression analysis showed that altruism remained the only significant independent predictor of nursing career choice after adjustment for gender, satisfaction with choosing nursing, having a family member who is a nurse, and having a family member in need of care (β = 0.433, <i>p</i> &lt; 0.001). The model explained 29.7% of the variance in nursing career choice (R² = 0.297; Adjusted R² = 0.263).</p> Conclusions <p>It is important to support altruism values in the education process for students who choose nursing for both idealistic and pragmatic reasons. It is recommended that guidance and role model practices that will improve students’ professional belonging, professional values and ethical awareness should be emphasized.</p>