Physicians are frequently called upon to take on leadership roles. These roles can come in various forms, ranging from academic leadership roles (eg, division or department chief or chair) to educational leadership roles (eg, clerkship or residency program director) to leadership roles in a practice setting (eg, director of a practice group). Although some of the desired skills and competencies for the leader may be specific to particular roles and responsibilities, others are more generic and applicable to any of these leadership positions. In this chapter, I will concentrate initially on the generic aspects of leadership and conclude by discussing some of the challenges that are more specific to hospitalists and to the hospital environment. In addition, instead of trying to review the voluminous leadership literature, I will present a personal perspective, based upon my own experiences in a variety of leadership positions over many years. I will divide the discussion of leadership into four components: the personal attributes that a leader should demonstrate, the skills that should be acquired, a suggested approach for trying to reach a goal, and leadership challenges for hospitalists in the hospital environment.