Background: Role clarity helps nurses to focus on the patients' needs and enables a shift from ‘provider-driven' to patient-centered care. In contrast, higher role ambiguity was associated with greater severity. of emotional exhaustion, thereby increasing the occurrence and development of work alienation in nurses. Aim: to assess role clarity and its impact on nursing staff work alienation at Malawi Specialized Hospital. Research design: A descriptive correlation research design was utilized in this study. Setting: The study was conducted at Malawi Specialized Hospital. Subjects: All staff nurses available (N=353), who worked at Malawi Specialized Hospital during the data collection period. Tools: two tools were as follows: tool (I), the first part was personal data, and the second part was the Role Clarity Questionnaire. Tool (II) Work Alienation Scale. Results: There was a high level of role clarity among the highest percentage of the studied nursing staff; the majority of them had a moderate level of total work alienation. Conclusion: There was a strong negative correlation between perceived role clarity and work alienation among nursing staff at Malawi Specialist Hospital. Recommendation: Fostering a supportive work environment to reduce work alienation, continuous professional development opportunities for new nurses, and implementing mentorship programs for knowledge sharing and role clarification