The purpose of this study was to examine role structures and processes and their impact on job satisfaction for oncology advanced practice nurses (APNs) in Ontario. APNs caring for adult, paediatric or palliative patients in integrated regional cancer programs, tertiary care hospitals or community hospitals and agencies were invited to complete a mailed self-report questionnaire. A total of 73 of 77 APNs participated in the study. Most APNs (55%) were acute care nurse practitioners employed by regional cancer programs or tertiary care hospitals. Adult patients with breast or haematological cancers and those receiving initial treatment or palliative care were the primary focus of APN roles. APN education needs related to specialization in oncology, leadership and research were identified. Overall, APNs were minimally satisfied with their roles. Role confidence ( b =.404, p =.001) and the number of overtime hours ( b =-.313, p =.008) were respective positive and negative predictors of APN job satisfaction. Progress in role development is described, and recommendations for improving role development and expanding the delivery of oncology APN services are provided.