This literature review discusses the role of leadership in High Reliability Organizations (HROs) in healthcare and in adopting technological innovation. These organizations operate in high-risk environments and depend on effective leadership to manage the complexity of their environments and promote a continuous safety culture. Leaders in HROs play a fundamental role in adopting new technologies, such as artificial intelligence and information systems, ensuring these innovations contribute effectively to patient safety and operational efficiency. This study demonstrates that although technological innovation offers significant benefits, including improved diagnostic accuracy and reduced medical errors, it also presents challenges such as costs, patient privacy, and resistance to change, all of which require committed leadership for successful adoption and implementation.