The purpose of this study was to contribute to career counseling and career guidance for nursing students by investigating the influences of self efficacy and major satisfaction on career decision level of nursing students. Methods: For this study, data were collected from 383 nursing students from Busan and South Gyeongsang Province Data collection was done during the period November, 2017. A descriptive survey design was used and data were collected using questionnaires from a sample of 380 nursing students. Data were analyzed using descriptive statistics, Mann Whiney U test, Kruskal-Wallis test, Pearson correlation coefficient and multiple regression with SPSS WIN 22.0. Results: Career decision level had a significant correlation with self-efficacy and major satisfaction. Fits aptitude (β = 0.14, p = 0.001), score (β =-0.11, p = 0.004), major reselect (β = 0.11, p = 0.016), hospital employment (β = 0.10, p = 0.011), self efficacy (β = 0.33, p < 0.001), general satisfaction (β = 0.18, p = 0.003), social perception satisfaction (β = 0.15, p = 0.003) were significant predictors of career decision level. Conclusions: It is necessary to develop effective career support programs according to type of motivation, career plans to improve nursing students' self efficacy and satisfaction in the nursing major.