Background <p>The unprecedented demographic shift toward an aging global population poses substantial challenges to healthcare systems worldwide, particularly in China. Despite the increasing demand for specialized geriatric nursing, a trend has emerged in which nursing students consistently demonstrate a reluctance toward pursuing careers in geriatric nursing, resulting in a critical shortage of qualified healthcare professionals in this essential field.</p> Objectives <p>This study aimed to examine the interrelationships among nursing students’ attitudes toward older people, their geriatric nursing competence, and their motivation to pursue careers in geriatric nursing; and to investigate the potential mediating role of geriatric nursing competence in the relationship between attitudes toward older people and geriatric nursing career motivation.</p> Methods <p>A cross-sectional survey was conducted using a convenience sample at Wenzhou Medical University from June 2023 to August 2023. Data were collected using the Chinese version of the Kogan’s Attitudes toward Old People (KAOP) scale, Geriatric Nursing Career Motivation Questionnaire, and Geriatric Nursing Competence Scale for Clinical Nurses which used an online questionnaire. Structural equation modeling (SEM) was used to test the hypothesized mediating role of geriatric nursing competence.</p> Results <p>This study recruited 529 nursing students across various academic years. Pearson analysis revealed a positive correlation between attitudes toward older people and geriatric nursing competence (<i>r</i> = 0.106, <i>p</i> &lt; 0.05), as well as between attitudes toward older people and geriatric nursing career motivation (<i>r</i> = 0.375, <i>p</i> &lt; 0.01). SEM revealed that attitudes toward older people had a significant direct effect on the motivation to choose a career in geriatric nursing (direct effect = 0.146, 95% CI [0.028–0.296]), with geriatric nursing competence partially mediating this relationship (indirect effect = 0.028, 95% CI [0.009–0.050], accounting for 16.09% of the total effect).</p> Conclusions <p>Attitudes toward older people had primarily direct effect on geriatric nursing careers motivation, with a modest indirect effect mediated by geriatric nursing competence. Educational initiatives should focus on fostering positive attitudes toward older people while complementarily enhancing students’ geriatric nursing competence to address the growing need for geriatric nursing professionals.</p> Clinical trial number <p>Not applicable.</p>