Background and aim: With the advancement of science and knowledge worldwide, ethical issues are increasing, and nurses' inability to face these challenges has a significant impact on the quality of health care. Moral courage in nurses helps overcome fear and immoral values, and the complexity of nursing work affects spiritual health and prevents nurses from adapting well to nursing challenges. 

Methods: This was a correlational study using a convenience sampling method. In 1403, nurses working at Amirul Mominin Hospital were selected, and the sample size was 221. The instruments used were Sekerka’s Moral Courage questionnaire, Ellison and Paloutzian's spiritual well-being scale, and the results were analyzed with SPSS version 26. 

Results: 186 nurses participated in the study, of which 119 were female and 67 were male. The mean scores of moral courage indicated that the moral courage score was higher in women and those with higher educational qualifications. Also, age and existential health were important factors in predicting moral courage, while religious health had no significant effect. 

Conclusion: The study's results showed that moral courage and spiritual health, especially in existential dimensions, play important roles in moral decision-making. Gender and age are also factors that can affect the level of moral courage.