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AIMS To test a path model evaluating the influence of cultural competence of nurses on patient satisfaction and the mediating role of patient trust. BACKGROUND In China, there has been an increase in medical disputes, which at times has resulted in physical assaults on healthcare providers. Enhanced patient satisfaction may reduce disputes and can perhaps be bolstered by the improved cultural competence of providers. DESIGN A cross-sectional path analytic research design was used. METHODS A random sample of 583 hospitalized patients recruited from six tertiary comprehensive hospitals in Changsha, China in 2016 completed a face-to-face structured questionnaire. Measures included the Consumer Assessment of Healthcare Providers and Systems Cultural Competency Item Set, the Wake Forest Physician Trust Scale, the Patient Satisfaction with Primary Nurses Scale and the Patient Overall Satisfaction with the Hospital Scale. RESULTS Significant associations among cultural competence of nurses, patient satisfaction and patient trust were confirmed, and path analyses supported the proposed mediating role of patient trust. Furthermore, the cultural competence subscales of communication-positive behaviours, trust-building behaviours and shared decision-making were positively and significantly correlated with patient satisfaction. CONCLUSION Findings suggest interventions should be designed to improve nurse's cultural competence, especially in the domains of communication-positive behaviours, trust-building behaviours and shared decision-making, and trust, to improve patient satisfaction.