Background: Effective communication between nurses and patients is essential for delivering quality patient care, particularly in high-pressure settings such as emergency departments. Objectives: This study aimed to assess the barriers hindering effective nurse-patient communication, as perceived by emergency nurses employed at the teaching hospitals associated with Mazandaran University of Medical Sciences in Iran in 2023. Methods: This cross-sectional study recruited 184 emergency nurses from five university hospitals using a census method. The sample population consisted of nurses working in emergency departments affiliated with Mazandaran University of Medical Sciences from May to August 2023, in Iran. Data were collected using demographic and the Barriers to Nurse-Patient Communication questionnaires, a validated and reliable instrument that assesses four domains hindering effective communication between nurses and patients. The data were analyzed using SPSS version 22. Results: According to the calculations, 65.2% of the participants were female, with ages ranging from 23 to 54 years and work experience between 1 and 27.5 years. Additionally, 92.4% held a bachelor's degree, and 7.6% had a master's degree. The results showed that, according to the emergency nurses, the barriers to communication between nurses and patients in the four investigated areas, ranked from highest to lowest score, were occupational characteristics, environmental factors, personal-social factors, and patient’s clinical conditions. The highest obstacles identified were: In the field of personal-social factors, patient’s excessive expectations (4.05 ± 0.88); in the field of occupational characteristics, heavy workload (4.32 ± 0.90); in the field of patient’s clinical conditions, presence of a companion (3.17 ± 1.29); and in the field of environmental factors, lack of appreciation of nurses by officials (3.96 ± 1.09). The barrier scores did not significantly correlate with nurses’ demographic variables. Conclusions: According to the results, the biggest obstacles were in the field of job characteristics of the emergency nurses. Therefore, the findings of this research can help nursing managers identify and adjust communication barriers between nurses and patients to adopt more effective strategies for teaching and evaluating nursing communication skills, ultimately fostering effective communication between nurses and patients.