Prolonged surgical time is associated with a greater risk of death, longer stays in the hospital, and higher rates of postoperative complication. The current literature on outcomes of patients with prolonged surgical time is limited to descriptive research and offers no evidence about prevention of or early intervention for postoperative complications. This study examined the association between the outcomes of patients that experience prolonged surgical time and modifiable nursing resources within hospitals. Decades of research has shown that in hospitals with lower patient-to-nurse ratios, high proportions of bachelor-prepared nurses, high proportions of registered nurses to total nursing staff (i.e., skill mix), and a good nurse work environment, patients are more likely to have favorable postoperative outcomes. The benefits of these good nursing resources are most pronounced among patients with the highest clinical risk. This study aimed: 1) to evaluate whether and to what extent differences in hospital nursing resources are associated with outcomes of patients with and without prolonged surgical time and 2) to determine whether the effects of hospital nursing resources on patient outcomes are conditional on surgical time for patients with prolonged surgical times. Multiple linked secondary data sources including patient data from the Centers from Medicare and Medicaid Services (CMS), hospital data about nursing resources from the RN4CAST-US survey, and data of hospital structural characteristics from the American Hospital Association Annual Survey were used to perform a secondary-data analysis. Multivariable logistic regression and zero-truncated negative binomial regression models were estimated to determine the association between hospital nursing resources and patient outcomes. Staffing, education, and the work environment were associated with lower odds of mortality and failure-to-rescue for all surgical patients, and an outcomes advantage was found for patients with longer surgical times when they were in hospitals with low patient-to-nurse ratios, higher proportions of bachelor-prepared nurses, richer skill mix, and good work environments. Additionally, a good work environment was associated with substantially lower odds of mortality and failure-to-rescue for patients with the most prolonged surgical times.