Moral distress is a challenge to job satisfaction and quality nursing care among nurses in the nursing services. The main objective of this study was to identify if moral distress was prevalent among the nurses, assess the understanding of moral distress, identify the causes and preventive measures to moral distress among nurses in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A cross sectional descriptive survey design was used, the wards clustered and simple random sampling technique used to select 234 respondents from the seventeen wards in the hospital. A structured questionnaire was used to elicit responses from the nurses. The Statistical Package for Social Sciences version 22 was used for analysis of the data. Descriptive statistical technique used to compute the results. The result showed that all the nurses experienced moral distress but differ in their intensity as (40.8%) of the respondents frequently experienced moral distress, (33.7%) did not experience moral distress frequently while (25.5%) experienced moral distress once in a while. More than half (53.6%) of the nurses were aware of moral distress. Several factors were identified to be the cause among which few nurses to many patients during the shift (17.85%) was the major cause to moral distress. Effects of moral distress on nursing profession were, job dissatisfaction (5.2%) burnout (5.7%), anger (5.7%), headache (5.2%) and fatigue (4.9%). Some preventive measures identified are employment of more staff (20.1%) and improvement of salary scale (15.4%). It was therefore recommended that Ahmadu Bello University, Teaching Hospital Shika should provide measures to prevent factors that cause moral distresses among nurses in the hospital.