The prevalence of thirst in intensive care unit (ICU) surgical patients is high, and its impact is significantly harmful. Nurses play a crucial role in managing thirst. It is essential to develop targeted training programmes for nurses, focusing on their knowledge, attitude and practice (KAP).To investigate KAP regarding thirst management in surgical patients among ICU nurses and the potential influencing factors related to demographic characteristics.This is a cross-sectional study. From August to September 2023, a self-developed questionnaire was distributed online in the ICUs of 14 tertiary general hospitals in Shanghai, China. This questionnaire aimed to assess the KAP of ICU nurses concerning thirst management. Influencing factors were analysed using ANOVA and the rank-sum test. Spearman correlation analysis and stratified regression analysis were employed to evaluate the relationship among KAP. The study was reported according to the STROBE checklist.A total of 530 valid questionnaires were obtained online with a response rate of 86.60%. While ICU nurses generally held a positive attitude towards thirst management, there was a noticeable deficiency in knowledge and a lack of standardization in practice. Nurses with higher educational levels, lower academic titles, who had received training and who were familiar with the consensus and guidelines on thirst management had better attitude towards managing thirst. Younger nurses, those with less ICU working experience, lower academic titles, who had received training and who were acquainted with the guidelines showed better practice. It was observed that knowledge and attitude both had a significant positive influence on practice.KAP regarding thirst management of surgical patients among ICU nurses are interconnected and require enhancement. Targeted training, focused on the identified weakness and influencing factors, needs to be carried out.An innovative and stratified training system can improve the quality of practice, as well as contributing to the professional development of ICU nurses. Further, the findings of the study provide a foundational understanding of thirst management, promoting the advancement of related scientific research.© 2024 British Association of Critical Care Nurses.