Aim: To explore the differences in perceived patient safety culture in cancer nurses working in Estonia, Germany, the Netherlands, and the United Kingdom. Design: An exploratory cross‐sectional survey. Methods: In 2018, 393 cancer nurses completed the 12 dimensions of the Hospital Survey on Patient Safety Culture. Results: The mean score for the overall patient safety grade was 61.3. The highest rated dimension was “teamwork within units” while “staffing” was the lowest in all four coun‐ tries. Nurses in the Netherlands and in the United Kingdom, scored higher on “com‐ munication openness”, the “frequency of events reported”, and “non‐punitive response to errors”, than nurses from Estonia or Germany. We found statistically significant dif‐ ferences between the countries for the association between five of the 12 dimensions with the overall patient safety grade: overall perception of patient safety, communica‐ tion openness, staffing, handoffs and transitions and non‐punitive response to errors. Conclusion: Patient safety culture, as reported by cancer nurses, varies between European countries and contextual factors, such as recognition of the nursing role and education have an impact on it. Cancer nurses’ role in promoting patient safety is a key concern and requires better recognition on a European and global level. Impact: Cancer Nursing Societies in any country can use these data as an indication on how to improve patient care in their country. Recognition of cancer nursing as a distinct specialty in nursing will help to improve patient safety.