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Purpose: The purpose of the study was to investigate the effect of major satisfaction, self-esteem and nursing professionalism on college (life) adjustment in nursing students. Methods: Data were collected using structured questionnaires from 179 nursing students at a university located in Seoul. The collected data were analyzed through the mean and standard deviation, t-test, ANOVA, Pearson's correlation, and multiple regression analysis using SPSS 27.0. Results: As a result, the average major satisfaction was 4.08 out of 5, the average self-esteem was 3.02 out of 4, the average nursing professionalism was 3.87 out of 5, and college life adjustment was 3.77 out of 5. Major satisfaction, self-esteem, and nursing professionalism were statistically correlated with college life adjustment. Self-esteem (β=.33, p<.001), major satisfaction (β=.24, p=.003), and major satisfaction at the time of admission (β=.22, p=.002) had a significant effect on college life adjustment. These factors explained 47.7% of college life adjustment (F=24.22, p<.001). Conclusion: The findings suggest there is a need to develop an educational program for nursing students to improve their self-esteem and major satisfaction.