Leading for service quality and safety is an ethical and legal responsibility. This chapter explores law, theory, research and practice about the leadership of quality and safety in disability and mental health services. It argues for a shared leadership approach that recognises the positive contributions to quality and safety made by many different organisational stakeholders, from clients and their supporters to frontline workers, supervisors, managers, specialist staff, senior executives and board directors. As the formal organisational leaders, senior executives and board members have unique responsibilities for creating the overall organisational approach for achieving quality and safe practices and overseeing their effective implementation by others. As part of this, they are also responsible for building the leadership capacity of other organisational leaders.