Moral distress occurs when nursing faculty members recognize the ethically correct action but are hindered by organizational, professional, or cultural constraints. This cross-sectional descriptive-analytical study measured the level of moral distress among 207 nursing faculty members from Iranian universities of medical sciences using simple random sampling. Data were collected using a validated 36-item moral distress questionnaire comprising four dimensions (organizational threats, mental concerns, work constraints, ethical doubt) and a 5-point Likert scale (1 = rarely to 5 = always). Validity was confirmed with content validity index (SCVI = 0.92) and exploratory factor analysis (explained variance 49.45%), and reliability with Cronbachs alpha = 0.91, ICC = 0.99, and SEM = 0.148. Analyses were performed using SPSS version 18, including independent t-test, Levenes test, one-way ANOVA, and LSD post-hoc test. The mean total moral distress score was 98.42 ± 11.81 (standardized scale 0100: moderate level). Distribution of levels: low (3684; n = 76, 36.7%), moderate (84132; n = 130, 62.8%), high (132180; n = 1, 0.5%). One-way ANOVA showed a significant difference across age groups (F (2,204) = 8.069, p = 0.001); highest mean in the <35 years group (42.79 ± 11.25), followed by 36–55 years (36.48 ± 11.42) and ≥56 years (31.84 ± 13.05). No significant differences were observed by gender (t (205) = 1.129, p = 0.260; Levene F = 0.072, p = 0.788) or marital status (t(205) = 0.265, p = 0.791; Levene F = 0.900, p = 0.344). Mean dimensions (standardized): work constraints (41.22), organizational threats (32.26), mental concerns (28.24), and ethical doubt (21.77). Moderate moral distress predominates among nursing faculty in Iran, with greater intensity in younger, less experienced individuals and those in internal-surgical specialties. Key factors include managerial pressures, time shortages, and value conflicts. Suggested interventions include supportive organizational policies, mindfulness training, and curriculum revision to reduce distress and maintain educational quality.

moral distress nursing faculty Iran ethical challenges organizational threats work constraints age differences mindfulness training