Background: The prevalence of illicit drug use among young people is high, with many being highly vulnerable to substance abuse. The nursing profession is not immune to the impacts of substance misuse. Knowing the current levels of consumption of illicit drugs in nursing students will allow for the introduction of preventive actions. Methods: Multi-center, descriptive, and cross-sectional study involving nursing schools from four different countries (Spain, Belgium, France, and Brazil). A total of seven centers participated. An adapted version of the Global School-based Student Health Survey (GSHS) was used as a tool, which selected only the module on illicit drugs. Standard logistic regression analysis was performed. Results: A total of 496 nursing students participated in the study. Illicit drug shows positive representation among nursing students. A significant difference was observed between the gender and the age of first drug use, illicit drug consumption, cannabis use, and cocaine use ever in life, with higher use of illicit drugs by male, although at later ages than girls. The bivariate analysis, gender, problems as result of drugs, and nationality were significantly associated with the consumption of illicit drugs, cannabis, cocaine, and ecstasy ever in life. Conclusions: High rates of illicit drug use were found among nursing students, as well as factors that can influence consumption such as nationality or gender. These results can serve as a basis for the development of educational and policy interventions within nursing schools that are based on evidence, with significant implications for nurse educators, academic administrators, and practice.