Background: Basic life support (BLS) training is essential for emergency nurses to manage life-threatening situations effectively. However, differences in training, proficiency, and confidence levels are common, especially in resource-limited settings. Aim: This study evaluated the effectiveness of a structured Basic Life Support training program on nurses' competencies. Design: Quasi-experimental design. Sample and methods: The study was conducted in Menoufia University Hospital and included a convenience sample of 59 nurses (28 males and 31 females) working in the emergency department in the previous setting. The study used four data collection tools: Tool (1): Part I assess sociodemographic data, and part II Knowledge Assessment Questionnaire. Tool (2): Practical Skills Checklist. Tool (3): Confidence Levels Scale, and Tool (4): Training Barriers Questionnaire. Results: Significant improvements were observed after training, with knowledge scores increasing from a mean of 68.5 to 85.2 (p < 0.01), practical skills scores improving by 35.0% to 42.0% (p < 0.01), and confidence levels increasing from 3.2 to 4.7 on a 5-point scale (p < 0.01). Number of years of experience had a moderate to strong positive association with knowledge scores (p = 0.01), practical skills (p = 0.01), and confidence levels (p = 0.02), while age and gender showed weaker associations. Key barriers to BLS training included limited access (35.6%) and inadequate resources (32.2%). Conclusion: A structured BLS training program significantly improves nurses' knowledge, practical skills, and confidence. Focusing on barriers to training is critical to improving access and effectiveness, especially in resource-limited settings. The current study supports the integration of structured BLS training into continuing professional development to improve emergency care outcomes.