Moral distress is a significant problem in nursing. The concept of moral distress in the field of nursing was defined in 1984, subsequently followed by the development of numerous theories and the critical analysis of the moral concepts in nursing.The situations of ethical dilemmas in nursing practice are specifically correlated with the moral distress emerged. By nursing professional licencing the nurses have acquired the responsibility for providing the quality of healthcare and ensuring the patient safety. Moral distress occurs in the situations when the nurse can not act in accordance with her own moral values and the standard quality requirements of the professional practice due to internal and external constraints, that is when the nursing values and the perceived professional roles are incompatible with the requirements and the overwhelming views in the work environment. Data available in literature show the frequency and significant intensity of the specified problem in the nursing profession. The ethical dilemmas situations require moral courage for the loud advocacy of the patients and nurses interests. Specific forms of moral distress are present both in clinical nursing and in nurse managers at all levels of nursing management. Moral distress can have negative influence on the health of nurses, jeopardize heaalthcare quality and/or cause leaving the workplace and other. Preventive strategies in resolving the moral distress require timely recognition of the specified problem in the working environment and the application of interventions, with the key role of nurses employed as managers/leaders due to significant influence of organizational factors on the moral distress development.