Objective To investigate the current status of death coping ability, death attitude and stress state among emergency department nurses, and to analyze the relationship between the three. Methods Participants were selected using the convenience sampling method from emergency department nurses working at five tertiary hospitals in Chongqing between December 2024 and January 2025. Data were collected using a general information questionnaire, the Coping with Death Scale, the Chinese version of the Death Attitude Profile-Revised, and the Chinese version of the Perceived Stress Scale. Results A total of 246 valid questionnaires were retrieved. The average total score of death coping ability among emergency department nurses was (136.93±26.98), which fell into the moderate level based on the Coping with Death Scale classification criteria. Neutral acceptance was the predominant death attitude, with an average item score of (3.71±0.62), accompanied by the polarizing feature of coexisting death avoidance and death fear. The average total score of perceived stress was (26.19±5.61), indicating a state of stress overload. The results of hierarchical multiple linear regression analysis showed that age, neutral acceptance, approaching acceptance, educational background, and sense of loss of control had an impact on death coping ability (P＜0.05). Conclusion It is recommended to construct a three-level intervention system encompassing death education, stress management skills training, and individualized psychological support, so as to enhance emergency department nurses’ death coping ability and occupational mental health.