Aim <p>Explore the mechanisms by which servant leadership influences unethical pro-organizational behavior among medical staff, particularly the mediating role of work meaning and the moderating role of power distance.</p> Methods <p>A questionnaire survey was conducted among medical staff in more than ten public hospitals in Guangdong Province and Guangxi Zhuang Autonomous Region, China. The data were analyzed using SPSS 23.0 and LISREL8.71 statistical software for reliability and validity tests, descriptive statistical analysis, and the hypothesis was tested.</p> Results <p>Servant leadership had a significant positive effect on medical staff’s unethical pro-organizational behavior, and work meaning significance mediated the relationship between servant leadership and medical staff’s unethical pro-organizational behavior. In addition, power distance moderated the psychological processes through which servant leadership influences the medical staff’s unethical pro-organizational behavior.</p> Conclusion <p>Servant leadership and work meaning are predictive of unethical pro-organizational behavior among medical staff. Servant leadership not only has a direct effect on medical staff’s unethical pro-organizational behavior, but also has an indirect effect on medical staff’s unethical pro-organizational behavior through the work meaning. Power distance moderated the psychological processes through which servant leadership influenced the medical staff’s unethical pro-organizational behavior. Specifically, high power distance enhanced the influence of servant leadership on the medical staff’s unethical pro-organizational behavior relative to low power distance. The results of this study reveal the formation mechanism of medical staff’s unethical pro-organizational behavior, and governmental authorities and hospital management should be alert to the negative effects of servant leadership, and develop correct ethical values and work behavioral norms, While considering the positive role of servant leadership, it is also important to foster proper ethical values and workplace behavioral guidelines for medical staff. In addition, it is important to promote communication and interaction between leaders and subordinates, build high-quality superior-subordinate relationships, and reduce the power distance to prevent the induction of unethical behavior.</p>