Background <p>Incident reporting in critical care settings is essential for patient safety, yet underreporting remains a challenge. Leadership coaching has emerged as a potential strategy to enhance a culture of safety by empowering nurses to actively engage in incident reporting.</p> Aim <p>This study explores the role of leadership coaching behavior in incident reporting culture among critical care nurses and investigates the relationship between leadership coaching behavior and various subdomains of incident reporting culture among nurses in critical care units.</p> Methods <p>A cross-sectional study was conducted at all critical care units of Alexandria Main University Hospital, Egypt. Data were collected from a convenience sample of 240 critical care nurses via the Incident Reporting Culture Questionnaire and Leader Coaching Behavior Questionnaire. Correlation and regression analyses were utilized to achieve the aims of the study.</p> Results <p>Critical care nurses reported moderate levels of leadership coaching behavior (3.65 ± 0.82) and incident reporting culture (3.23 ± 0.50). Leadership coaching behavior correlated strongly with incident reporting culture (<i>r</i> = 0.617, <i>p</i> &lt; 0.001), particularly in terms of communication, learning from errors, and feedback provision. Hierarchical regression revealed that adding leadership coaching behavior increased the explained variance from 23.5 to 50.5% (ΔR² = 0.270, <i>p</i> &lt; 0.001), making it the strongest predictor.</p> Conclusions <p>The findings highlight the critical role of leadership coaching behavior in fostering an open and supportive incident reporting culture in critical care settings. Integrating coaching strategies into leadership development programs may enhance patient safety by encouraging transparency and accountability among nursing staff.</p> Relevance to clinical practice <p>Nurse managers should design coaching programs to empower nurses to identify and report safety concerns more effectively, resulting in more comprehensive data collection and enhanced risk management. Additionally, leadership coaching can be integrated into hospital policies and professional development programs, ensuring a long-term commitment to improving safety culture. Nursing schools can employ real-world scenarios to teach students how to navigate reporting systems and address patient safety concerns effectively.</p> Clinical trial number <p>Not applicable.</p>