Introduction <p>Although the perception of nursing has evolved, a gap persists between its professional and social image, partly due to limited public awareness of its progress. This perception is shaped by generational differences across five cohorts: Silent Generation (born before 1945), Baby Boomers (1946–1964), Generation X (1965–1980), Generation Y (1981–1996), and Generation Z (1997–2012), each influenced by distinct historical and cultural contexts.</p> Aim <p>This study explores how generational identity influences public knowledge and perception of nursing in Italy.</p> Materials and methods <p>This cross-sectional secondary analysis was conducted on a nationwide sample of Italian adults, excluding individuals working as nurses.</p> Results <p> Among 1299 public participants, significant generational differences emerged in knowledge of the nursing profession (<i>p</i> &lt; 0.001), with Generation Z reporting the highest scores (12.54 ± 2.84) and the Silent Generation the lowest (9.69 ± 2.78). Overall perception of the profession did not differ significantly across generations, but analysis of specific factors revealed relevant distinctions. Generation Z reported the highest scores in professionalism and nursing education (57.25 ± 5.14, <i>p</i> &lt; 0.001), reflecting greater confidence in the academic and professional foundations of nursing. The Silent Generation rated prestige and social recognition highest (22.46 ± 4.16; <i>p</i> &lt; 0.001), indicating a more traditional view of nursing status. Additional significant differences emerged for gender dynamics (<i>p</i> = 0.001), personal characteristics (<i>p</i> = 0.001), and nursing challenges (<i>p</i> = 0.001).</p> Conclusions <p>Generational identity shapes public knowledge and perception of nursing in Italy, highlighting the need to address disparities through education, communication, and policy reforms.</p>