Background: Intensive care unit (ICU) nurses are at an increased risk of burnout and may have an intention-to-leave their jobs. The COVID-19 pandemic may increase this risk.Objective: The objective of this study was to describe the prevalence of burnout risk and intention-to-leave the job and nursing profession among ICU nurses and to analyse the relationships between these variables and the work environment after two years of the COVID-19 pandemic.Design: A national cross-sectional survey of all nurses working in Belgian ICUs was conducted between December 2021 and January 2022 during the 4th and 5th waves of the COVID-19 pandemic in Belgium. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to measure the work environment, intention-to-leave the hospital and/or the profession was assessed. The risk of burnout was assessed using the Maslach Burnout Inventory scale including emotional exhaustion, depersonalisation, and reduced personal accomplishment.Setting: Nurses in 78 out of 123 Belgian hospital sites with an ICU participated in the survey. Participants: 2,321 out of 4,851 nurses (47.8%) completed the entire online survey. Journal Pre-proofJournal Pre-proof2Results: The median overall risk of burnout per hospital site (high risk in all three subdimensions) was 17.6% [P25: 10.0 - P75: 28.8] and the median proportion of nurses with a high risk in at least one subdimension of burnout in Belgian ICUs was 71.6% [56.7 - 82.7]. A median of 42.9% [32.1 - 57.1] of ICU nurses stated that they intended-to-leave the job and 23.8% [15.4 - 36.8] stated an intent-to-leave the profession. The median overall score of agreement with the presence of positive aspects in the work environment was 49.0% [44.8 -55.8]. Overall, nurses working in the top 25% of best-performing hospital sites with regard towork environment had a statistically significant lower risk of burnout and intention-to-leavethe job and profession compared to those in the lowest performing 25% of hospital sites. Patient-to-nurse ratio ...