ackground: Nowadays, demographic shifting in the growth of elderly people becomes a challenge that faces the whole world, as it is associated with aging consequences, multiple comorbidities and cognitive impairment. Therefore, elderly needs comprehensive competent skilled nursing care. Aim of the study was to assess levels of competences, knowledge and attitudes of nursing internship students toward elderly care. Design: A descriptive study design. Setting: This study was conducted at Tanta University Hospitals through Internship Follow up Unit of Nursing Faculty. Study subjects: All nursing internship students (345) whom affiliated to Tanta Nursing Faculty in the internship year 2021/2022. Tool : A structured questionnaire tool including personal data, Nurse Competence in Care Home Scale (NCCHS), Knowledge about Older patients Quiz for nurses (KOPQ) and Kogan‟s Attitude Towards Old People Scale (KAOP)KAOP was used. Results: Two thirds 66.7% of nursing internship students had un- satisfactory competences regarding nursing care of elders. 87.2% of them had negative attitude toward elderly care. However, more than half of them (60.6%) had good knowledge score. There were significant negative correlation between total attitude, competencies and knowledge scores. Conclusion and recommendation: Although more than half of nursing internship students had good knowledge score, about two thirds of them had unsatisfactory competence and the majority of them had negative attitude toward elderly care. Therefore, Competencies, should be incorporated into specific, stand-alone courses focusing on care of the older adult, as well as integrated throughout the curriculum with emphasize on building positive attitude towards caring and working with elders.