BackgroundWith the continuous development of educational methods, desktop virtual reality technology has gradually attracted widespread attention. Although current research has shown that this technology can promote learning among nursing students, the mechanism and intrinsic factors are not yet clear. This study aims to explore the mechanisms and factors of the application of desktop virtual reality technology in nursing students' education and discuss the possible outcomes.MethodsThe realist review accords with the Realist and Meta-narrative Evidence Syntheses-Evolving Standards (RAMESES). The steps are mainly divided into the following three stages: (1) To determine the initial project theory; (2) To screen the published research and grey literature according to the inclusion criteria; (3) To analyze, extract, and synthesize the evidence of the included studies and then come to a conclusion.Data sourcesThis study included the original research from the following 8 databases from the establishment of the database to November 2024: CNKI, Wanfang Database, CBMdisc, VIP database, Pubmed, Cochrane, Web of Science, Embase.ResultsA total of 14 papers were included. Six mechanisms and six Context-Mechanism-Outcome combinations were identified, which explained the favourable factors related to the application of desktop virtual reality technology to the education of nursing students. Mechanisms include (1) personalized education, (2) clinically relevant cases, (3) dynamic visualization, (4) good education conditions, (5) gaming education, and (6) interactive education.ConclusionThis realist review demonstrates the underlying mechanisms, context, and outcomes, which will guide educators in using virtual reality technology to educate nursing students better.