To address increasing pressures for cancer survivorship care (CSC), provincial cancer agencies have introduced new models of post-treatment follow-up involving earlier transition of cancer survivors back to primary care (PC) providers. It is unknown how nurses in PC settings have responded to this practice change. The purpose of this qualitative descriptive study was to examine registered nurses' (RNs) perspectives of the strengths, gaps, barriers and opportunities for optimizing nursing roles in the delivery of CSC within PC settings. Participants completed a demographical questionnaire and semi-structured, in-depth telephone interview. Data collection and analysis were conducted concurrently. Data were analyzed using content analysis approaches. The sample included 18 RNs working in diverse PC settings across Ontario. Participants' involvement in CSC was limited, but it could be categorized into the following three themes: care coordination and system navigation, emotional support and facilitating access to community resources. Individual, practice setting and PC team factors influenced nurses' involvement in CSC. To the best of our knowledge, this is the first Canadian study to examine RN roles in PC settings related to CSC. There is wide variability and opportunity to enhance RNs' roles and involvement in CSC.