Nutritional decisions regarding commercial foods by handlers play a crucial role in diners' health, either for good or bad. This emphasizes the importance of understanding the connection between nutrition literacy and the confidence of gatekeepers in taking nutrition decisions and inherent hurdles. The limited research on this subject within the restaurant sector, combined with increasing eating out and the relatively weak governance of food and nutrition safety in developing economies, motivated this study. A survey involving 497 cooks and chefs in restaurants in Ghana, drawing on the nutrition literacy theory, revealed that overall nutrition literacy significantly influences confidence in nutrition decision-making of chefs and cooks. However, higher probabilities of this influence were observed among chefs compared to cooks, and there were additional variations in the impact of specific dimensions of nutrition literacy on confidence across independent and hotel-based restaurants. Opportunities, therefore, exist for improving the nutritional quality of foods prepared in restaurants through ongoing targeted interventions to enhance nutrition literacy among these professionals and undo barriers.