Background: High attrition and academic underperformance have been highlighted among students who speak English as an additional language (EAL) in higher education, and a lack of language skills is often cited as a key explanatory factor. Although the relationship between English-language skills and academic performance among EAL students has been established, group differences between international and domestic EAL nursing students is not known. Objectives: The aim of this study was to compare attrition rates and academic performance of international and domestic EAL nursing students, taking into consideration levels of English-language usage and socio-demographic characteristics of these groups. Design: A prospective correlational study. Participants and Methods: From 2010 to 2012, nursing students at a large Australian university, who attended an orientation session before course commencement, were invited to complete a survey to assess their English-language usage. Data collected included students' enrolment status and GPA at 12. months. Findings: Compared with their domestic counterparts, the attrition rate of international EAL students was significantly lower (7.9% versus 13.3%, p = 0.018). Similarly, international students also had higher GPAs (4.1 versus 4.0, p = 0.011). Although the levels of English-language usage were not related to academic performance, recent arrivals in both international (p=0.047) and domestic (p = 0.001) student groups had higher GPAs. Conclusion: This study suggests that language acculturation, indicated by English-language usage and the length of stay in the host country, was not sufficient to ensure successful transition into the academic environment for either international or domestic EAL nursing students.