Abstract: Early childhood is a critical period characterized by rapid physical, cognitive, language, social, and emotional development. Developmental delays occurring during this period can significantly affect a child’s long-term health, educational attainment, and quality of life. Globally, millions of children experience developmental difficulties, yet a substantial proportion remain unidentified until school age, resulting in missed opportunities for early intervention. Developmental delay screening serves as a fundamental strategy for the early detection of developmental concerns and facilitates timely referral, assessment, and intervention. Nurses occupy a pivotal position in this process because of their frequent contact with children and families across primary care, community, school, and hospital settings. This narrative review examines the concept of developmental delay screening in early childhood, the burden and determinants of developmental delays, contemporary screening approaches, validated screening tools, and evidence-based practices supporting early identification. Particular emphasis is placed on nursing roles in developmental surveillance, screening implementation, family education, referral coordination, and interprofessional collaboration. Current evidence indicates that structured developmental screening integrated into routine child health services improves detection rates and enhances developmental outcomes. Despite advances in screening methodologies, challenges such as limited resources, inadequate professional training, cultural barriers, and inequitable access to services continue to hinder effective implementation. Strengthening nursing competencies, promoting family-centered care, and adopting standardized evidence-based screening protocols can significantly improve early childhood developmental outcomes. This review highlights the essential contribution of nurses in advancing developmental health and provides recommendations for practice, education, research, and policy.