ABSTRACTPerioperative nurse turnover rates range from 12% to 18.8%, and approximately 75% of perioperative managers reported at least one vacancy in 2021. Perioperative leaders are challenged to mitigate nurse turnover effectively because factors contributing to a nurse's decision to leave their job are not well defined. The purpose of this qualitative study using classic grounded theory was to explore perioperative nurses’ turnover decision‐making processes. We used social media to recruit participants and then conducted 26 interviews to collect data. We completed comparative analysis of the data and developed the Perioperative Nurse Turnover Decision‐Making Theory, which describes the influence of the dimensions of perioperative nurse well‐being (ie, physical and emotional well‐being, career development, work‐life balance, compensation, workplace culture) on their decision to leave an OR position. Perioperative leaders should consider the nurses’ decision‐making process when developing and implementing interventions aimed at reducing turnover.