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This study aimed to understand the development of clinical reasoning among nursing students in the decision-making process regarding health technologies. This is a qualitative, descriptive, exploratory, and cross-sectional study, conducted with 33 nursing students from a university in brazillian southernl. The data was collected through semi-structured interviews, which were recorded, between March and May 2023. The data was processed using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software, and Discursive Textual Analysis was performed. The results revealed the students understanding of technologies, perceiving them as facilitators and enhancers of nursing work and health care, as well as reporting experiences of inadequate or outdated use of health technologies by professionals, professors, and colleagues. Regarding the factors considered for the implementation of health technologies, cost-benefit, the patient’s clinical condition, the team's knowledge, and nursing's role in relation to the technologies were described. Clinical reasoning for decision-making was described as a gradual process that must be strengthened during the course and refined through academic contact with professional practice. Finally, students reported difficulties in evaluating and implementing health technologies, and highlighted the support from professors, colleagues, and professionals in decision-making. Thus, the study achieved its proposed objectives, enabling reflection on the decision-making process related to health technologies, based on the development of clinical reasoning, and shedding light on the qualification process of future nursing graduates.