Background: Paternalistic leadership is a style of leadership in which the leader merges strict discipline with the empathy of a paternal figure and moral character in a personalized climate to enable nurses perform more effectively and efficiently and help them reduce cynical behaviour toward the hospital. Aim of the study: Compare influence of head nurses' paternalistic leadership on hospital cynicism and job performance among intensive care nurses at Tanta Main University Hospitals and EL-Mehalla General Hospital. Subjects and Method: Research design: A descriptive, comparative, via cross-sectional research design was used. Subjects: Available nurses working at Tanta Main University Hospitals' ICUs (n=295) and EL-Mehalla General Hospital (n=301). Tools: Three tools were used for data collection: Paternalistic Leadership Scale, Organizational Cynicism Scale and Nurses' job Performance Observational Checklist. Results: The majority of nurses perceived a high level of paternalistic leadership from the head nurses at Tanta Main Hospital compared to the minority of nurses at El-Mahalla General Hospital. The majority of nurses perceived a low level of hospital cynicism at Tanta Main Hospital, while above half of nurses perceived a moderate level at El-Mahalla General Hospital. The majority of nurses at Tanta Main Hospital had a satisfactory level of job performance contrary to slightly more than half of nurses at El-Mahalla GeneralHospital. Conclusion: There was a significant influence of head nurses' paternalistic leadership on hospital cynicism at both setting (Tanta Main and El-Mahalla General Hospital). Also, head nurses' paternalistic leadership affects nurses' job performance at Tanta Main Hospital. However, there was no relation between head nurses' paternalistic leadership and nurses' job performance at El-Mahalla General Hospital. Recommendation:Develop training program for head nurses to improve leadership practices in order to reduce cynicism and improve staff performance.