Aim To compare nursing leaders’ and employees’ perception of leaders’ leadership style, personality characteristics, and managerial competencies and to determine the associations between these factors. Methods The study included 4 out of 5 Slovenian major hospitals selected from the hospital list; 1 hospital refused to participate. The employees of these hospitals represent 30% of all employees in nursing in Slovenian hospitals and the 509 employees included in the study represent 6%. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting of 134 statements evaluated on a 5-point Likert-type scale. The relationship between demographic data, leadership style, leaders’ personality characteristics, and leaders’ training and managerial competencies was analyzed by correlation and multivariate regression analysis. The study took place in April 2009. Results Leaders and employees significantly differently evaluated 13 out of 14 managerial competencies of the leaders, where leaders rated themselves higher for vision and goals, communication, conflict resolution - agreement, compromise, adjustment, motivation, interpersonal relationships, problem solving, delegation, teamwork, decision making, emotional intelligence, and human resources development. Employees rated the leaders higher for managing changes and conflict resolution - dominance and avoidance.. Multivariate regression analysis showed that managerial competencies were explained by leadership style, leaders’ training, leaders’ characteristics, and type of employment in 86.1% of cases. Conclusion Leaders in nursing too frequently used inappropriate leadership style. Forming a unique model for all health care institutions in the country would facilitate the evaluation of competencies and constant monitoring of leaders’ work results.