Objective To systematically evaluate ICU nurses’ experiences of moral dilemmas to inform the development of evidence-based interventions for moral dilemmas. Methods Computerized search of relevant databases for qualitative studies on ICU nurses’ experiences of ethical dilemmas was conducted with a time frame of construction to July 2023. The quality of the included literature was evaluated using the 2016 Australian Joanna Briggs Institute （JBI） Center for Evidence-Based Health Care qualitative research quality assessment tool，and the results were integrated using meta-integration methods. Results A total of 16 papers were included，54 findings were distilled，and 8 categories were grouped to form 3 integrated findings：negative physical，psychological，and cognitive behavioral experiences of ICU nurses；root causes of ethical dilemmas of ICU nurses；and ways of coping with ethical dilemmas of ICU nurses. Conclusion Nursing managers should pay attention to the physical and psychological discomfort experience brought by moral dilemmas to ICU nurses，and should use a variety of interventions to actively respond to moral dilemmas，so as to reduce the level of ICU nurses’ moral dilemmas and improve the quality of nursing services.