Background Perioperative hypothermia is a common yet preventable condition in surgical patients and is associated with serious adverse outcomes, including increased bleeding, surgical site infections, cardiac events, and prolonged hospital stays. Effective hypothermia prevention is a critical indicator of surgical patient safety. This study examines the knowledge and practices of surgical nurses in managing perioperative hypothermia, highlighting implications for evidence-based nursing care and patient safety. Methods A descriptive, cross-sectional design was used, including 108 surgical nurses from a university hospital. Data were collected through face-to-face interviews using a structured questionnaire whose content validity was confirmed by experts and pilot tested. Results Among participants, 63.8 % had not received prior training on hypothermia management. Nurses without training had a mean knowledge score of 14.1 ± 3.8, significantly lower than those with prior training. The most commonly employed active warming method was the forced-air warming system (97.4 %), while the most common passive method was the use of socks (97.4 %). Knowledge levels were positively associated with education, professional position, and years of clinical experience, whereas age and length of service in surgical units showed a slight negative association. Furthermore, the number of warming methods used correlated positively with knowledge level. Conclusions Surgical nurses demonstrate a moderate level of knowledge regarding perioperative hypothermia management, with gaps particularly evident in thermal protection strategies for normothermic patients and the application of certain active warming methods. Findings underscore the importance of structured, continuous professional education to enhance nurses' competence and improve perioperative patient safety.