How were monarchy, gender, and nationalism entwined? Through contextualized comparisons of selected case studies (two generations of royal women in four countries: Bulgaria, Greece, Romania, and Serbia/Yugoslavia), this article explores, in gendered terms, the instrumentalization of nursing as an evolving relationship between state building, warfare, welfare, and voluntary organizations. It argues that certain queens’ interventions in nursing successfully contributed to the “naturalization” of the ruling foreign dynasties in the Balkans and to the militarization of charity. Through such “soft power” they mobilized nursing in different ways to carve out an autonomous space and visibility in wartime as queen-nurses and in peacetime as queen-benefactors. In both cases, royal women personified the “curing” and “caring” dimensions of the modernizing state. Queens’ honorific leadership clearly linked the monarchy and the philanthropic sector but also discreetly expanded the power of the nationalizing state. Queens skillfully promoted a gendered culture of sacrifice, by representing women as caring “by nature,” and thus reinforced neo-traditionalist patriarchal regimes and weakened women’s effectiveness in pursuing their political and economic demands.