Abstract: With societal development and accelerated population aging in China, the demand for high-quality nursing services continues to grow, placing the nursing sector in a dual scenario of challenges and opportunities that necessitate parallel advancements in development and reform. Clinical practice guidelines (CPGs), as critical tools for enhancing nursing quality and standardizing evidence-based care, face multifaceted challenges including complexities in evidence integration, methodological and reporting irregularities, barriers to multidisciplinary collaboration, and suboptimal clinical adherence. However, emerging opportunities—such as optimized methodological frameworks, the application of implementation science, and the integration of digital and intelligent technologies—are creating new pathways for advancing high-quality nursing practice. This article elaborates on the necessity of developing rigorous nursing CPGs and analyzes the current opportunities and challenges in their formulation, dissemination, and implementation, aiming to provide theoretical insights for strengthening guideline-driven nursing care.