Cardiothoracic surgery (CVTS) has evolved significantly over the past decades, with advances in surgical techniques, technology, and perioperative care. The role of the CVTS nurse has become increasingly vital, encompassing preoperative, intraoperative, and postoperative patient management. This narrative review examines the evolving responsibilities, competencies, and challenges faced by CVTS nurses in modern cardiac and thoracic surgical care. A structured literature search was conducted across PubMed, Scopus, and Google Scholar, focusing on studies published between 2010 and 2025. Inclusion criteria comprised articles describing the roles, training, and impact of CVTS nurses, while studies unrelated to surgical nursing or non-English publications were excluded. The review highlights key functions including patient assessment, hemodynamic monitoring, surgical assistance, pain management, patient education, and coordination of multidisciplinary care. Challenges such as workload, stress, and need for advanced training are discussed. The findings suggest that CVTS nurses are central to improving patient outcomes, optimizing recovery, and supporting surgical teams. Future directions emphasize formalized training programs, competency-based assessments, and recognition of CVTS nursing as a specialized profession.