Telenursing involves addressing clients' health needs through information, communication, and web-based systems, facilitating the delivery, management, and coordination of care using telecommunication technology. This study aimed to evaluate the knowledge and perceptions of telenursing among nursing students in nursing institutions in Lagos State. This study utilized a descriptive research design, with a convenience sampling technique used to recruit 257 respondents. Data were collected using a self-structured questionnaire, and responses were analyzed using descriptive statistics with SPSS Version 25. The stated hypothesis was tested using chi-square analysis. The results indicated that the majority of participants were within the 18–21 years age group (108, 42.0%). Most respondents (88.7%) demonstrated a high level of knowledge about telenursing, while 29 (11.3%) exhibited a low level of knowledge. In terms of perception, 182 (70.8%) had a positive perception, while 75 (29.2%) displayed a poor perception of telenursing. Identified barriers to telenursing included a shortage of nurses (221, 85.9%), lack of interest (184, 71.6%), limited knowledge of telenursing (230, 89.5%), inadequate ICT device supply (249, 96.9%), insufficient funding from hospital management (247, 96.1%), lack of policy (222, 86.4%), inadequate power supply (241, 93.8%), poor team spirit among nurses (184, 71.6%), lack of administrative commitment (222, 86.4%), and poor Attitudes towards telenursing (214, 83.3%).The analysis revealed no significant relationship between academic level and knowledge of telenursing among nursing students (P = 0.407, X² = 1.798a). However, there was a significant relationship between knowledge and perception of telenursing (P = 0.016, X² = 5.766a) among nursing students in nursing institutions. In conclusion, the majority of respondents demonstrated a high level of knowledge and a positive perception of telenursing. Consequently, hospital administrators are encouraged to invest in and enhance ICT infrastructure within healthcare facilities to facilitate the efficient implementation of telenursing services.