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The aim of this cross-sectional descriptive study was to compare the different leadership styles based on perceptions of nurse managers and their staff.Nurse managers' styles are fundamental to improving subordinates' performance and achieving goals at health-care institutions.This was a cross-sectional study. A questionnaire developed by Ekvall & Arvonen, considering three leadership domains (Change, Production and Employee relations), was administered to all nurse managers and to their subordinates at a city hospital in north-east Italy.The comparison between the leadership styles actually adopted and those preferred by the nurse managers showed that the preferred style always scored higher than the style adopted, the difference reaching statistical significance for Change and Production. The leadership styles preferred by subordinates always scored higher than the styles their nurse managers actually adopted; in the subordinates' opinion, the differences being statistically significant in all three leadership domains.The study showed that nurse managers' expectations in relation to their leadership differ from those of their subordinates. These findings should be borne in mind when selecting and training nurse managers and other personnel, and they should influence the hospital's strategic management of nurses.