The progress of nursing in Nigeria cannot be measured solely by the number of nurses trained or hospitals staffed. It must also be judged by the extent to which nursing has developed a clear professional identity, competent leadership, appropriate autonomy, ethical discipline and an effective voice in the formulation of health policy. This paper examines the professional status of nursing in Nigeria in the context of changing health needs and increasing expectations of the health professions. It considers the historical image of the nurse, the relationship between education and professional recognition, nursing leadership, participation in decision-making, interprofessional relations, professional unity, regulation, ethics and the responsibilities that accompany autonomy. The paper argues that autonomy is not separation from the health team, nor is professional status achieved through titles alone. Rather, nursing must demonstrate a distinct body of knowledge, accountability for practice, commitment to research, high educational standards and service to the public. Recommendations are made for strengthening nursing leadership, professional organizations, educational advancement, representation in health policy and unity within the profession.