Background: Clinical dishonesty is a complex problem that threatens the health and safety of patients. This study aimed to investigate the relationship between clinical dishonesty and perceived clinical stress in nursing students. Method: This cross-sectional correlational study was conducted on 395 nursing students from 4 nursing colleges. The data were collected using a demographic information questionnaire, Nursing Student ' s Perception of Clinical Stressors, and a 12-item researcher-made questionnaire to evaluate the frequency of clinical dishonesty in the previous semester, the frequency of witnessing dishonest behavior among peers, and the perceived severity of unethical behavior. Results: In this study, 89.1% of the students stated that they had committed at least one dishonest clinical behavior in the previous semester. The frequency of clinical dishonesty was significantly correlated with the frequency of observing dishonesty among peers (r = 0.053, p<0.01), perceived severity of unethical behavior (r = − 0.4, p<0.01), and perceived stress of students in the clinical setting (r = 0.28, p<0.01). Moreover, there were significant differences in the frequency of clinical dishonesty by gender (p = 0.006), the interest in the field of study (p = 0.004), and academic year (p = 0.002). Conclusion: The frequency of clinical dishonesty among nursing students is high and needs attention. Furthermore, considering the positive relationship between dishonesty and perceived clinical stress, it is essential to teach effective strategies to nursing students to empower them to cope with clinical stress. Background Academic dishonesty is deliberate complicity in the deceptive performance of one's own or another's academic work [1], which is an extremely complex issue [2]. According to educational theories, poor learning environments, lack of ethics training by the university [3], poor communication with peers and teachers (according to social psychologists) [4], and some cultural factors are associated with academic dishonesty [5]. Although it is assumed that academic dishonesty among nursing students is lower than that among students of other majors, studies have shown that the trend of dishonest behaviors in nursing students is similar to that of other majors [6]. The continuing growth of academic dishonesty in nursing education is of concern to nursing institutions and educators in many countries [7, 8]. Previous studies have shown that nursing students are likely to commit dishonest behavior in both the clinical setting and the classroom [9, 10]. Some studies showed that 13% of students recorded the vital signs that they had not