Background <p>Hospital pharmacists play a pivotal role in ensuring the safe and effective use of medications, thereby supporting the quality of care and the resilience of health systems. Identifying the factors influencing turnover intention among hospital pharmacists and implementing strategies to maintain an appropriate talent pool can contribute to strengthening public health and improving patient outcomes. This study aimed to identify the factors influencing turnover intention among hospital pharmacists in South Korea and provide implications for strategies to support pharmacist retention.</p> Methods <p>A cross-sectional survey was conducted in July 2024 with 592 full-time pharmacists employed in tertiary and general hospitals using proportional stratified sampling by hospital type and region, representing 16.0% of the pharmacists working in these hospitals. The questionnaire incorporated items from Mitchell’s Job Embeddedness theory, the Korean Occupational Stress Scale, and Singh’s turnover intention scale, and underwent expert content validation and exploratory factor analysis. Multivariable linear and logistic regression analyses were performed to determine the factors associated with turnover intention after adjusting for key demographic and institutional characteristics.</p> Results <p>Among the 592 respondents, 255 (43.1%) had high turnover intention, with shorter employment durations associated with higher turnover intention scores. Within job embeddedness, factors significantly reducing turnover intention included fit to organization_task, organization-related sacrifice_direct, link to organization_task, and link to community_transverse. Within job stress, the factors that significantly increased turnover intention were lack of rewards, job demand_density, and organizational system_fairness. The identified associations were consistent across both linear and logistic regression models, supporting the robustness of the findings.</p> Conclusions <p>To retain skilled professionals, hospitals should improve their reward structures, foster a culture of fairness, and provide targeted support to junior pharmacists. Improving role fit in task assignments may help reduce turnover risk and enhance workforce stability.</p>