Background: Transitioning to full oral feeding is a critical developmental milestone for preterm infants and a primary requirement for hospital discharge. The Premature Infant Oral Motor Intervention (PIOMI) is a novel, evidence-based technique designed to strengthen oral muscles and decrease the length of hospital stays. Despite its clinical benefits, the successful implementation of PIOMI depends heavily on the competence and attitudes of neonatal intensive care unit (NICU) nurses. Objective: This review aimed to appraise the current state of knowledge and practices among neonatal nurses regarding the implementation of PIOMI. Method: A systematic approach was employed to search electronic databases including PubMed, Ovid (Medline), and Elsevier. The search focused on peer-reviewed articles published within the last five years using specific keywords such as "PIOMI," "oral feeding practices," and "neonatal nurses' knowledge." Strict inclusion criteria ensured the selection of empirical studies focused on NICU settings and nurse-led interventions. Result: Seventeen studies met the inclusion criteria. The review of literature reveals that while PIOMI significantly improve feeding efficiency and reduce hospital stays, a notable disparity exists between nurses' positive attitudes and their practical competence. Several studies highlighted that structured training programs significantly improve nurses' knowledge levels and the speed at which infants achieve independent feeding. Conclusion: The literature underscores the efficacy of PIOMI in optimizing developmental outcomes for preterm infants. However, the gap between nurse enthusiasm and clinical skill necessitates the integration of standardized, competency-based educational programs into NICU protocols. Collaborative efforts to involve parents in feeding interventions and the adoption of standardized assessment scales are crucial for fostering the successful transition to oral feeding and improving the overall quality of neonatal care.