Purpose: The purpose of this study was to determine the relationship between the leadership orientations of nurses and their clinical decision-making skills. Design/methodology/approach: This descriptive study was conducted between June and December 2018 on nurses working at three hospitals in Turkey. This study was completed with 1,100 nurses. The Personal Information Form, Leadership Orientation Scale and Clinical Decision-Making Scale in Nursing were used for data collection. Findings: A significant correlation was found between the leadership orientations of nurses and age, sex, institution where they were employed, time spent in the profession, being in a management position and satisfaction with the current unit of employment (p < 0.05), and a significant correlation was found between clinical decision-making skills of nurses and age, sex and occupational status (p < 0.05). Furthermore, a significant correlation was found between the mean scores of the Leadership Orientation Scale and Clinical Decision-Making in Nursing Scale (p < 0.05). Originality/value: The development of leadership orientations of nurses positively affects their clinical decision-making skills. In this respect, it is important to instill effective leadership orientations in nurses and to incorporate novel training methods in nursing education to develop accurate and timely clinical decision-making skills.