Background <p>In culturally conservative settings, the gap between attitudes and behaviors regarding organ transplantation remains a challenge among future healthcare professionals. Drawing on the Theory of Planned Behavior, this study examines how religious orientation and systemic distrust may be related to attitudes toward organ donation among nursing students in Eastern Turkey.</p> Methods <p>The study employed a descriptive-correlational research design. The study was conducted with undergraduate nursing students at a public university in eastern Turkey. Data were collected using questionnaires such as the Descriptive Information Form, the Organ Donation Attitude Scale, and the Religious Attitude Scale.</p> Results <p>A notable inconsistency was observed between theoretical willingness to donate and actual behavior; although some students considered organ donation, the proportion of those who held a donor card was extremely low. The majority of participants had not received formal education on the subject. Religious orientation was not found to be a direct determinant of general attitudes toward organ donation. However, a relationship pattern was observed: while religious cognition was positively associated with systemic distrust, internalized religious belief may function as a factor that alleviates bodily fears. Male students exhibited higher levels of anxiety regarding systemic distrust, while female students demonstrated higher scores on emotional religiosity.</p> Conclusions <p>Attitudes toward organ donation appear to be linked more to systemic mistrust and bodily concerns than to direct religious opposition. The low prevalence of donor card ownership and the limited availability of formal education may indicate that current nursing curricula do not fully address region-specific sociocultural factors.</p>