Patient experience is the sum of all interactions that influence a patient's perception across the continuum of care. Hospital executive leaders' leadership competencies impact their organizations' patient experience performance. This national, cross-sectional, qualitative study aimed to identify what health care leadership competencies mattered most to patient experiences in U.S. inpatient acute care hospitals. The target population encompassed all inpatient acute care hospitals. A purposive sampling method was used to select n = 28 executive leaders who represented 28 hospitals of the target population. Results from thematic analyses indicated 15 leadership competencies that matter most to patient experience: change leadership, self-awareness, self-confidence, human resources management, collaboration, team leadership, initiative, accountability, professional and social well-being, verbal communication, process and quality improvement, community collaboration, analytical thinking, achievement orientation, and organizational awareness.