Abstract Background: Nursing students' physical and mental health is a vital prerequisite for patient safety, academic success, and developing clinical competence. However, health monitoring systems vary widely across jurisdictions, and comparative policy evidence remains limited. This study aimed to compare the health monitoring systems and governance structures for nursing students in Finland, Japan, and Iran to derive actionable policy implications for Iran. Materials & Methods: This descriptive-comparative study used Bereday’s four-stage model (description, interpretation, juxtaposition, and comparison). Relevant primary and secondary data were retrieved through systematic searches of national legal and policy frameworks, official institutional portals, and international databases including PubMed, Scopus, and Web of Science up to 2024. The comparative analysis focused on organizational oversight, physical and mental health screening protocols, psychosocial support mechanisms, information infrastructure, and procedures for safeguarding professional competence. Results: The three countries demonstrated distinct operational models. Finland employs an integrated, student-centered approach grounded in functional capacity and SORA legislation, operationalized nationally through the Finnish Student Health Service (FSHS/YTHS). Japan relies on a standardized, statutory model emphasizing regulatory compliance, annual health examinations, and institutional accountability. Conversely, Iran’s system is characterized by dispersed regulations, university-level decentralized execution, and the absence of a standardized, unified national protocol. Finland and Japan demonstrated robust integration between health policies, centralized electronic health documentation, and systematic follow-up mechanisms, facilitating evidence-informed student support. Conclusion: The core distinction among the three systems lies not merely in the scope of clinical examinations, but in the institutional philosophy and the systematic link between student health services and fitness-to-practice assurance. Establishing a cohesive national framework, standardizing physical and psychological monitoring protocols, and implementing interoperable health data registries represent strategic priorities for optimizing nursing student health monitoring in Iran.