Background: Healthy school physical environment affects the day to day health and well being of the students. It should be organized in a way that reduces or eliminates safety hazards for all students and school personnel. The nurse collaborates with other school members to provide effective intervention to prevent the exposure of students to potentially physically harmful conditions. They must have the educational knowledge and background to be actively involved in promoting a safe healthy school environment. Objectives: The present study aimed to know the role of the nurse in maintaining the healthy physical environment in primary schools in Alexandria. Methods: The study was conducted at the governmental primary schools in the seven educational zones. The study included all nurses working in 350 primary schools. The study was fulfilled through a cross-sectional approach. Results: A total number of 251 nurses accepted to be included in the study, their mean age were 45.87±10.61 years, the majority of them (89.2%) were married and had children, about 57.0% had a certificate of health visitor diploma. The results showed that knowledge, attitudes and practices of nurses regarding maintaining healthy school physical environment are adequate in some aspects and inadequate in another. As regards knowledge, only one quarter of nurses has the required knowledge, while one third of them did not have enough knowledge. However, there were unsatisfactory attitudes and practices in maintaining healthy school physical environment. Conclusion: The study revealed that a significant positive relationship was found between knowledge of nurses and their qualifications and marital status.