Abstract: Early recognition of patient deterioration is a cornerstone of patient safety and quality care in medical-surgical settings. Hospitalized patients often exhibit subtle physiological and behavioral changes hours before serious adverse events such as cardiac arrest, respiratory failure, sepsis, or unplanned intensive care unit admissions. Medical-surgical nurses, due to their continuous bedside presence, are uniquely positioned to identify early warning signs and initiate timely interventions. This review article explores the concept of patient deterioration, common clinical indicators, contributing factors, and the pivotal role of medical-surgical nurses in early detection and response. It also examines the use of early warning scoring systems, clinical judgment, communication strategies, rapid response systems, and technological innovations supporting early recognition. Barriers to effective detection, educational needs, and future directions in nursing practice are discussed. Strengthening nurses’ competencies in early recognition of deterioration has significant implications for reducing morbidity, mortality, and healthcare costs while enhancing patient outcomes and safety.