Background <p>The leadership style of head nurses is widely recognized as a critical factor influencing nurse job satisfaction, which in turn affects retention rates and the quality of patient care. However, the extent to which this relationship holds in settings with unique organizational challenges remains insufficiently explored. Therefore, this study aimed to examine the relationship between the leadership styles of head nurses and nurse job satisfaction in Iran.</p> Methods <p>This descriptive-analytical cross-sectional study was conducted in southeastern Iran from November 2024 to June 2025. A random sample of 381 nurses and a census of 30 head nurses were selected. Data were collected using the Leader Effectiveness and Adaptability Description (LEAD) questionnaire to assess leadership styles and the Warr-Cook-Wall scale to measure job satisfaction. Data analysis was performed using hierarchical regression.</p> Results <p>The most prevalent leadership style identified in the head nurses’ self-assessments was Supporting (S3: 31.17%), while the nursing staff most frequently perceived their leaders’ style as Coaching (S2: 27.45%<b>).</b> Nurses reported a relatively high mean job satisfaction score (58.54 ± 11.95). Importantly, hierarchical regression analysis revealed no statistically significant relationship between head nurses’ leadership styles and nurse job satisfaction (<i>p</i> &gt; 0.05).</p> Conclusion <p>The findings show that a direct relationship between leadership style and nurses’ job satisfaction was not evident in this context, possibly due to the influence of strong organizational factors and the limited managerial experience of head nurses. These findings suggest that future research should focus on organizational conditions and the development of adaptive leadership skills.</p> Clinical trial number <p>Not applicable</p>