Abstract Back ground: The importance of nurses' tendency to speak up in clinical settings for improving patient safety and treatment quality has drawn a lot of attention. Aim: This study aimed to explore safety management approaches and its relation to staff nurses' speaking up for patient safety behaviors at Mansoura University Children Hospital. Setting: The study was conducted at Mansoura University Children Hospital. Research design: A descriptive correlational research design was used. Subjects: Convenience sample of nurses (130) was used. Tools: Two tools were used namely: Safety Management Approaches Questionnaire and Speaking Up For Patient Safety Questionnaire. Results: As regard control - based safety management, stressing the importance of safety rules and regulations was found the highest. Concerning commitment - based safety management, creating safety awareness was found the highest. As regard speaking up for patient safety behaviors, the one simulated behavior (vignette) was found the highest. The study results revealed that about three quarter of the studied nurses had moderate speaking up for patient safety behaviors level. Conclusion: There was statically significant negative correlation between control - based safety management approach and speaking up for patient safety behavior. Recommendation: Encourage leaders to use two safety management systems in tandem rather than just one because both of them are crucial for monitoring patient safety, giving nurses communication and assertiveness training to enable them to speak up with competence and confidence, and establishing channels for the private and anonymous reporting of safety issues.