Background: Nursing universities have a short history of using electronic online exams as an integral part of students' assessment that have the potential to trigger anxiety in nursing students. The success of the electronic online exams can be measured based on students' self-satisfaction and attitudes. Aim: Identify nursing students' anxiety, self-satisfaction and attitudes toward electronic online exams. Design: Descriptive exploratory research design was used. Setting: The study conducted at the Faculty of Nursing, Tanta University. Tools: Three tools were used. Tool (I): Test Anxiety Questionnaire, Tool (II): Student's satisfaction toward electronic online exams and Tool (III): Student's attitudes toward electronic online exams. Results: 63.4 % of nursing students had moderate level of anxiety toward electronic online exam, and 62.9% of students expressed moderate level of satisfaction. Whereas, 83% of nursing students in first academic year had positive attitude toward online exam compared to 49.1% of fourth academic year. There was a highly statistically significant relation between sex, academic years and student' anxiety. Also, it was a highly statistically significant relation between academic year, number of previous online exams and student' attitudes. Conclusion: Female students had a higher anxiety than male toward online exam and first year students had higher scores of positive attitude toward online exam than other students. Moreover, student's anxiety correlates positively with the poor attitude and negatively with student's satisfaction. Recommendations: The nursing students on the third and fourth academic year should be prepared well with frequent electronic online quizzes or exams.