Submitted in fulfilment of the requirements for the Doctor of Nursing in the Faculty of Health Sciences, Durban University of Technology, Durban, South Africa, 2017. / Background In recent times, the internationalization of nursing education and the collaboration with international academic partners has become a priority of academic institutions’ strategic plans and visions. This coupled with the fact that the world has entered a critical period in terms of addressing health and preparing nurses to address health needs has made this study timeous. In view of these historical challenges, nursing education institutions, nursing colleges and universities with nursing faculties in South Africa have, in recent years, engaged in international partnerships. These collaborative partnerships have influenced the delivery and facilitation of transnational nursing education (TNE) or cross-border nursing programmes, both nationally and internationally. Challenges raised with regards to TNE delivery systems are often related to issues revolving around academic design and implementation. Further issues such as the differences between the host institution’s general goals, the academic programs, student characteristics and social and cultural dimensions as compared to the awarding institution, add to these challenges. Aim The aim of this study was to explore the perspectives and practices and experiences of nursing education institutions, academic leaders and graduates, who were involved in TNE. Based on the findings of this study, the ultimate aim was to develop guidelines for the implementation of TNE in NEIs. Methodology A qualitative multiple case-study approach was employed to explore institutional perspectives and practices related to TNE. The population comprised nursing education institutions, academic leaders and nursing graduates that were involved in TNE programs. In order to draw comparison between South African TNE practices and perspectives with international best operating practices relating to TNE, other global academic leaders and institutions involved in this type of education were invited to participate in the study. Institutional records were analysed for descriptions and patterns related to conceptual issues, structures and processes that are known to impact either negatively or positively on TNE. Results The study findings revealed that access to ‘importing’ and ‘exporting’ of nursing programs are still faced with many challenges by all stakeholders. It was also revealed that the lack of guidance during TNE ventures allude to cross-border nursing education being a ‘for profit’ arrangement. From the findings the researcher was able to propose and develop guidelines for the implementation of TNE for nursing education institutions, academic leaders and students. It is hoped that these guidelines will be considered as a tool to improve TNE delivery in terms of quality assurance, accreditation, registration, and qualification recognition. / D