Introduction The ability of nurses to hold competing emotions is at the heart of a number of recent studies. Empathy is an emotional resource in nurse-patient interactions and promotes positive experiences at work. On the contrary, emotional dissonance resulting from nurse/patient interactions is usually considered to lead to negative outcomes, such as job dissatisfaction (Brotherigde & Grandey, 2002). Objective The aim of this study is to investigate the extent to which empathy and emotional dissonance are associated with organizational citizenship behavior among a group of Italian nurses. Method A questionnaire was distributed to 222 nurses, working in two multidisciplinary hospitals in a North region of Italy. Results Results support the hypothesis that both cognitive and emotional empathy have significant effects on nurses’ organizational citizenship behavior directed at the organization. Cognitive empathy explained significant variance in organizational citizenship directed only at specific individuals. Conclusion These findings confirm that cognitive and emotional empathy have different impact on nurses’ organizational citizenship behavior. Further studies are required to inform education or for application in clinical settings.