Background: Effective pain assessment and management is widely reported as sub optimal due to inadequate knowledge and negative attitudes among nurses. Aim:To determine nurses' attitudes, knowledge and education needs towards acute pain management in acute hospital settings Methods: PRISMA (2021) and guidelines from the University of York, CRD (2009) informed the design and conduct of this review. We included studies with registered nurses involved in direct adult patient care and acute pain management in hospital settings.