Aim: The purpose of this review was to describe findings of a systematic review of studies that examine the relationship between nursing leadership and patient outcomes. Background: With recent attention directed to the creation of safer practice environments for patients, nursing leadership is called on to advance this agenda within organizations. However, surprisingly little is known about the actual association between nursing leadership and patient outcomes. Methods: Published English-only research articles that examined formal nursing leadership and patient outcomes were selected from computerized databases and manual searches. Data extraction and methodological quality assessment were completed for the final seven quantitative research articles. Results: Evidence of significant associations between positive leadership behaviours, styles or practices and increased patient satisfaction and reduced adverse events were found. Findings relating leadership to patient mortality rates were inconclusive. Conclusion: The findings of this review suggest that an emphasis on developing transformational nursing leadership is an important organizational strategy to improve patient outcomes.