Background: Paternalistic leadership is a style in which the leader combines high discipline with the compassion of the father figure and ethical integrity in a personal atmosphere 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: All 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 head nurses' paternalistic leadership 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 more than 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 compared to slightly more than half of nurses at El-Mahalla General Hospital. 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. K