This chapter provides an alternative view of traditional leadership, describing assumptions of leadership in global health and how these assumptions, along with leadership skills, can be adapted fluidly among members of global health projects in order to maintain partnerships. Global health nursing leadership occurs within organizations and the highest levels of government, but the concept of leadership in global health nursing extends to nurses working within nongovernmental organizations or serving as volunteers on health care teams. Critical team leadership roles include the following: convener, visionary, strategist, and team builder. Leadership roles will continue to emerge throughout the partnership as the need arises, and partners will assume leadership roles according to their personal and professional skills as well as experience. The chapter then provides two case studies that demonstrate the challenges involved in maintaining partnerships between academic institutions in different countries.