Background: Successful implementation of patient safety plans in a hospital necessitates, among other things, the leadership capacity of nurse managers. Patient care delivery errors and adverse events continue to occur for a variety of reasons, including a failure to follow recommended patient safety strategies. Certain leadership styles foster interactions with healthcare staff, resulting in work environments that promote positive patient outcomes. It is unclear what nurse managers believe about the type of leadership style that drives patient safety.Aim: The goal was to explore the nurse managers’ perceptions of leadership styles as an impetus to patient safety.Setting: The study was conducted at an academic hospital in the Tshwane District of Gauteng province.Methods: A qualitative exploratory and descriptive contextual design was used. Semi-structured face-to-face interviews were conducted with 20 purposefully selected nurse managers. A thematic data analysis method was used to analyse data.Results: Common leadership styles among nurse managers and challenges affecting the efficiency of nurse managers’ leadership styles emerged as themes.Conclusion: Nurse managers must have appropriate leadership styles to improve patient safety. Human and material resource shortages, as well as a lack of collaborative practice among healthcare professionals, jeopardise nurse managers’ ability to maximise patient safety.Contribution: The article provides insight into nurse managers’ perceptions of leadership styles as critical to improving patient safety. Recommendations included the need for a structured ongoing leadership training programme to develop and strengthen the skills of newly appointed and existing nurse managers.