Background: Gamification provides nursing students with a setting in which they can practice clinical reasoning and decision making in a realistic and secure way. The purpose of this study was to determine the influence of gamification on decision making in nursing students. Method: A quasi-experimental study was performed with a control group and an experimental group. A convenience sample was used to select the participants. A total of 191 nursing students participated. Participants were randomly assigned to one of the groups. Results: On comparing the control group and experimental group, statistically significant differences were found in the following patterns: vigilance, buck passing, and procrastination. Conclusion: Using gamification as part of nursing education increases satisfaction, creative thinking, and control, among other aspects, with little to no negative effects throughout the experience, which has a significant impact on decision making. [ J Nurs Educ . 2019;58(12):718–722.]