Authentic leadership in nursing prioritizes ethical conduct, transparency, and empowerment, hence enhancing work performance, care quality, and staff retention. This research examines literature from 2010 to 2023, evaluating the influence of genuine leadership on nursing outcomes. Research demonstrates that genuine leadership fosters innovation, work happiness, and employee engagement, while also enhancing patient safety and care quality. Research indicates a substantial association between real leadership and nursing performance, enhancing emotional commitment and decreasing negative incidents. Although genuine leadership fosters a favorable workplace atmosphere, its direct impact on nurse retention is inconclusive. Considering the persistent nurse shortages, comprehending the significance of leadership in staff welfare and patient care is essential. This study emphasizes the significance of incorporating real leadership into nurse administration to enhance healthcare outcomes and advocates for more research on mediating variables.