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Background The researcher identified that there is limited current research in palliative care and leadership styles. The number of patients living with life-limiting illness in the community is increasing (Mitchell, Loew, Millington-Sanders, et al. Br J Gen Pract. 2016;66(650):e647-53). The Parliamentary Office of Science and Technology (POST) identified that people are living longer with multiple long-term conditions. Home is chosen as a preferred place of death (PPD) by 56% of patients (Higginson, Daveson, Morrison, et al. BMC Geriatr. 2017 Nov 23;17(1):271), only 25% achieve their first preference. This could be due to accessibility of services (Mistry, Bainbridge, Bryant, et al. BMJ Open. 2015 Jun 29;5(6):e007492), essential to enable patients to achieve PPD. It has been identified that development, change and review of services is required to improve patient outcome and enable choice at end of life. The leadership role is considered as essential in the delivery and quality of healthcare services to improve patient outcome (National Palliative and End of Life Care Partnership. Ambitions for palliative and end of life care: a national framework for local action 2021-2026. 2021).This systematised review aims to investigate the influence of leadership styles within palliative care services, to establish if the leadership style applied in end of life care services impacts patient choice.Objective To systematically review literature to recognise and understand if leadership styles applied by end of life care services impact patient choice leading to positive patient outcome and patient choice at end of life.Methods Database searches of CINAHL, ProQuest and Emerald insight.Findings Eight studies were included in the systematised review. Four qualitative studies and four cross sectional studies. Following the analysis of the selected studies, thematic analysis identified six themes that impact leadership and patient outcome: Communication, patient-centred care, clinical leadership, the organisation, resources and job satisfaction.Conclusion Leadership styles do not have a direct impact on patient outcome but they do impact the staff who are providing patient care therefore increasing teamwork, collaboration and job satisfaction which leads to staff providing quality care and impacting patient outcome. Transformational leadership style was found to be a positive leadership style.