A good quality leader is vital in ensuring effective and efficient services rendered to patients. However, as to date, little is known on the leadership styles of managers in Military Hospitals in Malaysia and the region. The aim of this cross-sectional study was to determine the leadership styles and identify the influencing factors, among Military and Non-Military managers in five Military Hospitals in Malaysia. A pre-tested 20-item questionnaire was distributed to eligible managers in the hospitals. Based on the total score, the leadership style of managers was classified into Transformational (TS) and Non-Transformational style (N-TS). Among the 501 respondents, 375 (74.9%) of them were Non-military managers and 126 (25.1%) of them were Military managers. 46.8% (n=59) of the managers with military background practiced TS while only 27.7% (n=104) of Non-military managers have TS (X2 =15.662; p <0.001). Managers aged 40 years and above, male, with higher educational level, served longer in the service, attended in-service training and participated in other capacity building activities were more likely to practice TS. Analysis using stepwise multiple logistic regressions proved that predictors of TS style are educational level (AOR=2.319; 95% CI=1.300,4.134), working experience (AOR=1.075; 95% CI=1.049,1.102), Military managers (AOR=1.759; 95% CI=1.104,2.802) and attended in-service training (AOR=2.070; 95% CI=1.369,3.129). In conclusion, the Military Hospitals have the benefit of being managed by Military managers that practice TS. Educational level and in-service training are two most important elements that influence the practice TS among the managers in these Military Hospitals.