Objective To explore the employment challenges of higher vocational nursing graduates in Shanghai from the perspective of employment intention,so as to provide references for optimizing higher vocational nursing education. Methods A convenient sampling method was adopted. In December 2023,1 081 graduating students of the 2024 cohort majoring in full-time higher vocational nursing from 10 public and private colleges in Shanghai were selected as study participants. A self-developed questionnaire was used for the survey,and standardized telephone follow-up was conducted in April 2025. Results Among the 1 081 quasi-graduates,766(70.86%) were willing to engage in nursing work,247(22.85%) had moderate willingness,and 68(6.29%) were unwilling to work in nursing;817(75.58%) preferred tertiary hospitals as their first job choice,and 907(83.90%) preferred to work in Shanghai. Among the 373 valid follow-up data,the employment rates of graduates with high,moderate and low willingness to work in nursing were 72.28%(193/267),72.29%(60/83) and 52.17%(12/23),respectively. The proportions of those engaged in non-nursing work in the three groups were 8.29%(16/193),10.00%(6/60) and 41.67%(5/12),respectively. Passive further education accounted for 69.84%(44/63) of all graduates pursuing further education. Among unemployed graduates,40.91%(18/44) were waiting for recruitment opportunities in civil service or public institutions. Conclusion Higher vocational nursing graduates are faced with problems such as differentiated professional identity,singular employment preference,and institutional-oriented inertia in career decision-making,which lead to employment mismatch and career development bottlenecks. It is suggested to strengthen professional identity education in nursing education,establish a flexible diversion mechanism,broaden students’ employment horizons,construct an experiential employment guidance mechanism,and implement targeted measures and home-school collaboration at the graduation stage,so as to improve students’ clarity of career positioning and rationality in employment decision-making.