AIM: To explore how nurses across international settings support the sexual wellbeing of people living with inflammatory bowel disease through their clinical practice. DESIGN: Qualitative descriptive study. METHODS: Online semi-structured interviews and one focus group were conducted with nurses from Australia, Canada, Japan, the Republic of Ireland and the United Kingdom. The interviews were conducted in Japanese (for Japanese participants) and English (for the rest). A total of 28 nurses with extensive experience caring for people living with inflammatory bowel disease were recruited between May 2023 and December 2024 through snowball sampling. Data were analysed using thematic analysis. RESULTS: The overarching theme identified was 'careful exploration in real life practice' with the following primary themes: (1) building the foundation for sexual wellbeing care, (2) addressing sexual wellbeing issues as a team, (3) identifying sexual wellbeing needs and (4) providing personalised nursing support. These themes highlighted the lack of sexual wellbeing care education in nursing, leading to unpreparedness and low confidence among nurses who nonetheless strived to support people living with inflammatory bowel disease despite limited training and communication barriers. CONCLUSION: Nurses supported the sexual wellbeing of people living with inflammatory bowel disease by building trust and working collaboratively. They offered individualised care based on each patient's life context, fostering open communication. Despite cultural taboos surrounding sex, similar challenges and training needs were reported across target regions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study highlights the importance of addressing sexual wellbeing as a key component of holistic care for people living with inflammatory bowel disease. To achieve this, sexual wellbeing should be treated as a routine and important aspect of everyday nursing practice. Furthermore, nurses need to be empowered to play an active role in supporting sexual wellbeing and work in environments that facilitate open and respectful discussions. IMPACT: This study addresses the long-neglected issue of sexual wellbeing in inflammatory bowel disease care, which has rarely been explored in nursing research. Drawing on qualitative data from multiple countries, primarily Japan, it offers a new international perspective by illustrating how nurses engage with and support sexual wellbeing. The findings have implications for clinical practice, nurse education and global research on holistic chronic illness care. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research checklist was followed. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.