Abstract: Objective: To investigate nursing students' trust and acceptance of generative artificial intelligence (GAI). Methods: A total of 429 nursing students from Guangxi Medical University were selected as research subjects via convenience sampling from January to March 2025. The investigation was conducted using the artificial intelligence trust scale, and GAI acceptance scale. Results: A total of 429 valid questionnaires were collected. Among them, 386 nursing students (89.98%) reported having used GAI and 43 (10.02%) indicated they were only familiar with it but had never used it. There were statistically significant differences in the total scores and dimensional scores of the GAI acceptance scale, as well as the total scores and dimensional scores of the artificial intelligence trust scale, among nursing students with different educational backgrounds (P＜0.001). Among them, undergraduate nursing students (including those upgraded from junior college) had the highest total score on the GAI acceptance scale, with a score of 75.10±10.33; while junior college nursing students (including "2+3" program) had the lowest total score, with a score of 65.69±13.11. Nursing students who had used GAI scored significantly higher on the total GAI acceptance scale than those who were only familiar with it but had never used it (P=0.017). Multiple linear regression analysis further indicated that the total score of the artificial intelligence trust scale, and having an educational background of undergraduate (including those upgraded from junior college) or postgraduate, were positive predictors of GAI acceptance (P＜0.05). Conclusion: Undergraduates and graduate students demonstrate relatively high levels of trust and acceptance of GAI. Trust in AI is the primary driver of GAI acceptance. Educational practice should emphasize trust-building and tiered academic guidance to facilitate the effective integration of GAI into nursing education.