Objective To investigate the caring leadership among head nurses in secondary and tertiary hospitals in Hubei Province, and analyze its influencing factors, so as to provide a reference for developing precision strategies to improve nursing management competence. Methods A total of 2 838 head nurses from 48 secondary and tertiary hospitals in 15 cities of Hubei Province were enrolled via stratified sampling, then they were investigated by using a general information questionnaire and the Caring Leadership Scale for Head Nurses. Results The participants′ total score of caring leadership was (117.18±14.26), and the average item score was (4.33±0.54).Dimension scores ranked from the highest to the lowest were:maintaining common interests, charismatic appeal, promoting self-realization, kindness, and appreciating independence.Multiple linear regression analysis identified clinical working years, hospital grade, participation in humanistic care group standard training, and implementation of the group standard Management Specification for Humanistic Care in Ward Nursing (T/CALC 001-2022) as significant predictors of caring leadership （all P＜0.05）, which explained 23.8% of the total variance. Conclusion The caring leadership among head nurses in Hubei Province is relatively high, but presents a structural feature of "high fairness protection, low empowerment and fault tolerance".It is recommended to foster a culture of empowerment and fault tolerance, provide resource support and precision training for secon-dary hospitals, so as to facilitate standardized advancement of caring leadership.