Abstract This study examined the influence of maternal knowledge and maternal attitude on the practice of exclusive breastfeeding among working nursing mothers attending immunization clinics in General Hospitals in Akwa Ibom North-West Senatorial District. Two research questions and two hypotheses guided the study. The study adopted a descriptive survey design, and the population comprised 1,247 working nursing mothers who attended immunization clinics in the seven general hospitals within the district. A sample of 200 nursing mothers was drawn using a multi-stage sampling technique. Data were collected using a researcher-developed instrument titled Knowledge, Attitude and Practice of Exclusive Breastfeeding Questionnaire (KAPEBQ). The instrument was validated by experts, and reliability was established using Cronbach's alpha, yielding coefficients of .75 for knowledge and .80 for attitude. Data were analyzed using mean and standard deviation for the research questions, while a dependent t-test was used to test the hypotheses at the 0.05 level of significance. The findings revealed that maternal knowledge significantly influences the practice of exclusive breastfeeding among working nursing mothers in the study area. Similarly, maternal attitude was found to have a significant influence on exclusive breastfeeding practice. Based on these findings, the study concluded that both knowledge and attitude play critical roles in determining whether working nursing mothers adhere to exclusive breastfeeding recommendations. The study recommends strengthening health education programs to increase mothers’ knowledge and improve attitudes toward exclusive breastfeeding. It further suggests that health educators should intensify counseling and supportive interventions that address misconceptions and promote positive breastfeeding behaviors among working nursing mothers.