BackgroundThe escalating global nursing shortage, fueled by the migration of healthcare professionals from resource-constrained nations to those with greater economic prosperity, presents a formidable challenge to healthcare systems worldwide. Nepal, grappling with a significant brain drain of its nursing workforce, serves as a poignant illustration of this phenomenon. The departure of skilled nurses not only jeopardizes the country's healthcare quality but also underscores the urgent need to address the underlying educational and systemic deficiencies contributing to this trend. AimThe study aims to explore the early formation of migration intentions among undergraduate nursing students in Nepal and identify key factors influencing their decision to pursue opportunities abroad. DesignA descriptive qualitative research design. SettingsThe study was conducted at two urban nursing colleges in Nepal. ParticipantsSeventeen nursing students in their final year of undergraduate studies. MethodsData were collected via semi-structured interviews and analyzed using thematic analysis. ResultsThe thematic analysis unearthed four principal themes: (1) Aspirations Beyond Borders: Structural and Systemic Catalysts; (2) Navigating Personal Ambitions; (3) Socio-Political Currents Influencing Career Pathways; (4) Economic Incentives and Realities: Weighing the Prospects. ConclusionThe study's findings highlight the need for systemic changes to retain nursing professionals in Nepal. There is a significant gap between policy initiatives aimed at improving the status of nursing and the persistent challenges nursing students face. This gap fosters disillusionment and drives migration intentions. The research underscores the urgent need to address systemic deficiencies, empower nurses, and ensure equitable recognition. These actions are crucial to cultivating a sustainable nursing workforce dedicated to advancing health equity.