Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2566 2578 Zohreh Gehisari College of Public Health, Zhengzhou University, Gaoxin District, Zhengzhou, 450001, Henan, China Elnaz Hashemzadeh Department of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran Sevda Fazlizade Psychiatric Nursing, Tehran Azad Medical University, Tehran, Iran Hamed Razaghpour Department of Nursing, Za.c., Islamic Azad University, Zanjan, Iran Mohammad Abdi 1. Department of Emergency and Critical Care Nursing, Zanjan University of Medical Sciences, Zanjan, Iran 2. Department of Medical Education, Social Determinants of Health Research Center & Education Development Center (EDC), Zanjan University of Medical Sciences, Zanjan, Iran Maryam Asadi Aghajari Department of Nursing, Maragheh Branch, Islamic Azad University, Maragheh, Iran 2025 05 02 2025 09 18 Background: The intensive care unit environment poses a substantial risk for Post-Traumatic Stress Disorder (PTSD) among nurses, stemming from frequent exposure to traumatic events and patient death This systematic review aimed to determine the epidemiology of PTSD among ICU nurses. Methods: We systematically searched PubMed, Scopus, and Web of Science from Jan 2000 to Dec 2024 for studies reporting PTSD prevalence among ICU nurses. Inclusion criteria were observational studies with validated PTSD assessment tools; Exclusion criteria included case reports and non-English publications. Data were synthesized using a random-effects model. Results: The study reviewed 25 papers that provided quantitative data and were included in the analysis; the sample sizes varied from 98 to 748 ICU nurses. The published frequency of PTSD among ICU nurses has been identified to range between 3.3% and 64%. The pooled prevalence was estimated to be approximately 32.78 % (CI 95%[31.6%, 33.9%]). The specific factors influencing risk for PTSD included exposure to traumatic events: having a high workload, staff shortage, and organizational issues with the absence of psychological support, as well as individual characteristics, including younger age and prior mental health disorders. The impacts of PTSD included psychological distress, poor sleep quality, feelings of loneliness, and a reduced health-related quality of life. Conclusion: The high prevalence of PTSD among ICU nurses underscores an urgent need for targeted interventions and support programs. Providing essential support through staffing, psychological resources, and resilience training is critical. Further research should examine the longitudinal course of PTSD and evaluate intervention outcomes. https://ijph.tums.ac.ir/index.php/ijph/article/view/31182 https://ijph.tums.ac.ir/index.php/ijph/article/download/31182/8719