BACKGROUND: Children with neurodevelopmental disorders admitted to child and adolescent psychiatric units often exhibit aggressive behaviors, posing challenges for nurses. It is unclear what experiences and challenges nurses have in these cases within the unique environment of hospitalization. PURPOSE: This study aimed to elucidate the difficulties faced by nurses in providing care for children due to their aggressive behavior in these units. METHODOLOGY: Qualitative descriptive research was conducted through semi-structured interviews with nurses with over 3 years of clinical experience in child and adolescent psychiatric units. The interviews were recorded and transcribed verbatim, and text units related to nursing difficulties were extracted and categorized. RESULTS: We interviewed 21 nurses, averaging 44 years old, with 6.8 years of experience in child and adolescent psychiatric units. Five categories of difficulties were identified: (1) building patient-nurse relationships, (2) encouraging behavior modification, (3) managing aggressive behavior, (4) facilitating reflection on aggressive behavior, and (5) establishing and maintaining appropriate behavior. CONCLUSIONS: Nurses face numerous challenges in providing care for children with aggressive behavior. Despite experiencing physical and mental burdens in managing aggressive behavior, nurses strive to help children achieve social adjustment. Establishing systems to address nurses' difficulties can enhance the quality of nursing care.