For the past 30 years, an increasing number of EMS leaders have called for more uniformity in emergency medical services (EMS) leadership, with the time now upon us to heed that call. This quantitative study examined the leadership styles of EMS leaders within the four sectors of fire-service, hospital, volunteer, and commercial, which together make up the 911-EMS system in New York City. Specifically, the study examined the Machiavellian, bureaucratic, and transformational leadership styles to determine which of them was most prevalent amongst NYC EMS leaders. Said leadership styles were examined within the context of type of EMS organizational sector and leadership level within that organizational sector. The results indicated a definite relationship with the transformational leadership style within and across the four sectors; in essence showing there is minimal impact on leadership style based on organizational sector culture, or level within the organization. This is not to say that the bureaucratic and Machiavellian styles had no role, just that the transformational style seemed most prevalent based on survey responses. It should be noted that these relationships were somewhat weak at best, pointing out that while this new knowledge can be used to further enhance the discussion of EMS leadership, more evaluation and testing using a larger sample, and/or different geographical location, may provide greater strength to these conclusions, or perhaps identify different results entirely.