Aim: To reveal the prevalence of nursing students with special educational needs in Japan. Method: A mail survey of 833 nursing programs was conducted. Nurse educators were asked to report on their program's profiles and the number of extremely difficult students who belonged to the March 2011 class of graduates. They were also asked to fill a modified questionnaire developed by the Ministry of Education, Culture, Sports, Science and Technology about each extremely difficult student. Results: Among the 14,325 students enrolled the class of 2011, 146 students (1.02%) were identified as having one or more special educational needs for "listening," "speaking," "reading," "writing," "math," "reasoning," "inattentiveness," "hyperactivity/impulsivity," or "social interaction/restricted interests." The most prevalent need was "social interaction/restricted interests," followed by "listening" and "inattentiveness." These students had the most difficulty participating in "nursing care for patients during clinical practicum." Conclusion: The proportion of nursing students with special educational needs is small but may have a large impact on the clinical practicum. Evaluation and support systems at multiple levels, including entrance examinations, course placement, and special educational programs, are warranted. (c) 2014 Elsevier Ltd. All rights reserved.