Effective nursing leadership in healthcare organizations improves healthcare quality and increases patient satisfaction. In the literature, patient satisfaction has been considered as an important indicator of high quality and effective healthcare service. To determine the relationship between ward-level leadership and patient satisfaction of nursing care in teaching hospitals of Iran University of Medical Sciences. In this cross-sectional study, the sample consisted of 34 head nurses, selected on the basis of census sampling as well as 102 staff nurses and 170 patients, selected by random sampling. The cohort was chosen from 34 wards, including 10 internal medicine wards, 15 general surgery wards, 4 emergency wards and 5 intensive care wards, associated with all teaching hospitals of Iran Medical Science University. Data were collected using the multifactor leadership questionnaire and patient satisfaction instrument. The findings revealed that 50% of the head nurses had a transactional leadership style, 29.4% of them had a transformational leadership style and remaining 20.6% had a passive-avoidant leadership style. No statistically significant relationship was found between the ward-level leadership and patient satisfaction with nursing care, but the highest mean score of patient satisfaction was found for wards under head nurses with a transformational style. Potential influence of transformational leadership may be directly dependent on the patients’ views towards care providers as members of the health care team. It is recommended to conduct this study in a larger scale and using higher number of samples in other hospital settings.