Background <p>Work-life balance has emerged as a critical issue in nursing, directly influencing job satisfaction, professional performance, and patient outcomes. Nurses’ ability to make timely and effective clinical decisions is essential for delivering high-quality care, yet it may be compromised by imbalances in their personal and professional lives.</p> Aim <p>This study evaluated the relationship between nurses’ work-life balance and their clinical decision-making skills and the quality of nursing care they provide.</p> Methods <p>The study was cross-sectional with 252 nurses working in a hospital between March 21 and April 10, 2025. The data were collected using the Descriptive Information Form, Work Life Balance Scale, Clinical Decision Making Scale in Nursing and Quality Nursing Care Scale. Data were analyzed using t-test, ANOVA, Pearson correlation and multiple regression analyses.</p> Results <p>According to the study findings, nurses’ work-life balance (48.55 ± 8.93) was below average, while their clinical decision-making (134.90 ± 13.68) and perceptions of quality nursing care (163.04 ± 18.05) were significantly above average. A positive and significant correlation (r: 0.369, <i>p</i> &lt; 0.001) was found between nurses’ clinical decision-making scores and the level of quality nursing care; No significant correlation was found between work-life balance and clinical decision-making and quality nursing care (<i>p</i> &gt; 0.05). However, a negative and significant relationship was found between the Negative Impact of Life on Work and the Clinical Decision Making in Nursing Scale (<i>r</i>=-0.240, <i>p</i> &lt; 0.001). A positive and significant correlation was found between the Negative Impact of Work on Life and the Clinical Decision Making in Nursing Scale (<i>r</i> = 0.140, <i>p</i> = 0.027) and the Quality Nursing Care Scale (<i>r</i> = 0.184, <i>p</i> = 0.003).</p> Conclusion <p>While the findings indicate that overall work-life balance is not associated with clinical decision-making and quality nursing care, they do suggest that life, and the negative impact of work on life, play a critical role. Therefore, nurses demonstrate that achieving work-life balance is a critical factor not only for individual well-being but also for patient safety and quality of care. The finding of a significant negative correlation between nurses’ low work-life balance and the negative impact of work on life, clinical decision-making, and quality nursing care suggests that developing strategies to support work-life balance at the institutional level will be an important step toward improving the sustainability and quality of nursing services.</p> Clinical trial number <p>Not applicable.</p>