Patient advocacy has long been recognized as a fundamental component of professional nursing practice. A comprehensive understanding of advocacy is essential for nurses to enhance patient safety and improve the quality of care. Despite its importance, several barriers may impede nurses’ ability to effectively advocate for patients. This study aimed to explore nurses’ perceptions of patient advocacy and identify barriers that hinder its implementation. Methodology: An exploratory descriptive cross-sectional design was employed. A convenience sampling technique was used to recruit nurses working in primary and secondary healthcare institutions in Al Dakhiliya Governorate, Oman. Data were collected using a structured questionnaire comprising demographic characteristics and the validated Protective Nursing Advocacy Scale (PNAS) developed by Hanks (2008). Descriptive and inferential statistical analyses were conducted using SPSS software. Results: A total of 129 nurses completed the survey, yielding a response rate of 25.8%. Most participants were female (88.4%), aged 31–35 years (38.8%), married (91.5%), and held a bachelor’s degree in nursing (53.5%). The findings indicated that nurses in Oman actively engage in patient advocacy. However, several barriers were identified, including limited clinical experience, fear of employer punishment, and concern about negative professional consequences. Conclusion: Advocacy remains an integral aspect of nursing practice. Therefore, nursing education programs should emphasize the development of advocacy competencies and integrate comprehensive advocacy content into curricula. Furthermore, healthcare institutions should establish clear advocacy policies outlining procedures and responsibilities, while implementing protective measures to safeguard nurses from professional, personal, and legal repercussions associated with patient advocacy.