Objectives <p>This research aimed to generate consensus from Canadian public health experts on organizational leadership competencies for public health governance in Canada.</p> Methods <p>A three-step modified Delphi technique was used to build consensus. It included (1) identifying the list of competencies for organization leadership for public health governance based on a literature review and interviews, (2) conducting a consensus two-round modified Delphi survey with public health experts across Canada, and (3) holding an online deliberative dialogue to finalize the list of competencies and generate pathways for the uptake of competencies. Qualitative responses were analyzed using thematic analysis for Round 1.</p> Results <p>Sixty-two survey participants participated in Round 1, with a 72.58% retention rate in the second round of the Delphi. Round 3 had 12 public health experts participating in the online consensus dialogue. The Delphi technique generated 20 competencies that were identified across eight domains of systems thinking: policy development, implementation, evaluation; partnership and collaboration; equity and justice; organizational learning; oversight; resource stewardship; and legal authority.</p> Conclusion <p>This is the first-ever study in Canada to develop organizational leadership competencies for public health governance using a consensus-based approach. The results are relevant to public health and health care organizations interested in adopting or implementing organizational-level competencies. Future research needs to explore implementation and adaptation strategies of these competencies across various public health organizations.</p>