Nurses’ job satisfaction is an important factor influencing the quality of healthcare services in hospitals. Nurses with higher levels of job satisfaction tend to demonstrate better performance, stronger organizational commitment, and improved quality of patient care. Job satisfaction is influenced by various factors originating from within the individual (intrinsic motivation) as well as external factors related to the work environment (extrinsic motivation). This study aimed to analyze the influence of intrinsic and extrinsic motivation on nurses’ job satisfaction at Royal Prima Hospital Medan in 2025. This study employed a quantitative approach with an observational analytic design using a cross-sectional method. The population consisted of all nurses working at Royal Prima Hospital Medan, with a total sample of 195 respondents selected using the consecutive sampling technique. Data were collected using a Likert-scale questionnaire consisting of 25 items. Data analysis included descriptive statistics, classical assumption tests, multiple linear regression analysis, t-test, F-test, and coefficient of determination (R²). The results showed that achievement, recognition, responsibility and self-development, compensation, work environment and working conditions, and supervision simultaneously had a significant effect on nurses’ job satisfaction (F = 59.84; p < 0.001). Partially, achievement (p = 0.001), recognition (p = 0.002), responsibility and self-development (p = 0.024), work environment and working conditions (p = 0.001), and supervision (p = 0.017) had significant effects on nurses’ job satisfaction, while compensation showed a positive but non-significant effect (p = 0.082). The coefficient of determination (R²) of 0.581 indicates that 58.1% of the variation in nurses’ job satisfaction can be explained by the variables examined in this study.