Purpose: The study examined the effect of leadership styles on employee performance in public hospitals in Nigeria. Specifically, it investigated how transformational, transactional, and autocratic leadership practices influence healthcare workers’ performance outcomes, aiming to provide insights for improving workforce productivity and service delivery.

Methodology/Design: A quantitative research design was employed, using a structured questionnaire administered to 400 healthcare employees across selected public hospitals. Data were analyzed using descriptive statistics, correlation, and multiple regression analysis with SPSS version 26. Reliability and validity of the instrument were confirmed through Cronbach’s alpha, and expert review.

Findings: The results revealed that transformational (β = 0.45, p = 0.001) and transactional leadership (β = 0.31, p = 0.002) positively and significantly influence employee performance, while autocratic leadership (β = -0.27, p = 0.004) negatively impacts performance. These findings highlight that participative and motivating leadership approaches are more effective in enhancing staff productivity.

Implications: Hospital management should adopt transformational and transactional leadership practices while minimizing autocratic tendencies. Policymakers should implement leadership development programs and performance-based incentives to improve healthcare delivery.