Background: Sikkim has an alarming fertility rate of 1.1 as compared to the rest of the national average of 2.0. This might increase in the future as people don't want to talk about fertility issues openly. Nursing students are the future of nursing care. Nurses play an important role in imparting knowledge regarding fertility among the general public. This study was done to assess fertility awareness, knowledge, attitude, and practices among nursing students of a tertiary care hospital in Sikkim. Materials and methods: It was a cross-sectional study conducted among nursing students of a tertiary teaching hospital in East Sikkim. A total of 349 students who gave consent to participate in the study were asked to fill a predesigned, pretested, semi-structured, self-administered multiple response questionnaires with a fixed list of questions in a standard sequence. Based on the responses their knowledge, attitude, and practices were assessed. Results: Among the 349 participants, although 80% of the participants were aware of their fertile days, only about half of them had adequate knowledge. Although the actual level of knowledge was low, it was interesting to observe that more than 90% of participants had a positive attitude. Many participants had a false perception of practical fertility issues. Conclusion: Fertility-related knowledge was low among nursing students in Sikkim. Fertility-related issues should be included in the training curriculum for the nursing students.