Background <p>The leadership style of head nurses is an important factor that can influence nurses’ satisfaction with head nurses and overall performance in hospital wards. This study aimed to examine the relationship between head nurses’ leadership styles and nurses’ satisfaction with head nurses in specialized and general hospital wards.</p> Methods <p>This cross-sectional study was conducted among nurses and head nurses working in six teaching hospitals affiliated with Zanjan University of Medical Sciences, Iran. Using a census sampling method, 1,354 nurses from 71 hospital wards (31 specialized wards and 40 general wards) participated in the study. Data were also gathered using a three-part questionnaire that included a demographic form, the Fiedler and Chemers Leadership Style Inventory, and a Supervisor Satisfaction scale. Data were analyzed using SPSS version 26, with correlation, t‑tests, regression, and ANOVA at the ward level aggregation.</p> Results <p>The mean (SD) satisfaction with head nurses score during this study was 68.94 (6.26) in specialized wards and 66.11 (5.14) in general wards. Nurses in both ward types reported relatively high satisfaction with their head nurses. Also, integrated leadership (a balanced combination of task‑ and relationship‑oriented styles) in specialized wards and relationship-oriented leadership in general wards had the highest frequency. In contrast, task-oriented leadership had the lowest frequency in both wards. In the next step, the findings also indicate that both relationship-oriented and integrated leadership styles resulted in higher levels of nurse satisfaction than the task-oriented style (<i>P</i> &lt; 0.05). Finally, leadership styles explained 26% of the variance in nurse satisfaction with head nurses in specialized wards, and 16% in general wards.</p> Conclusion <p>Nursing staff satisfaction with head nurses was higher under integrated leadership in specialized wards and relationship-oriented leadership in general wards. Using relationship-oriented and integrated leadership styles rather than relying solely on task-oriented style may be a potential strategy for supporting nurses’ satisfaction in both specialized and general hospital wards.</p> Clinical trial number <p>Not applicable.</p>