The present work is an exploratory qualitative study on the role of management and leadership in hospice work and palliative care in Austria. Eight qualitative interviews with leaders of different hospice and palliative care facilities were carried out as well as three expert interviews. In doing so, the grounded theory approach was chosen for the epistemological foundation of research. Following the description of the research process, core empirical results are presented, discussed as well as theoretically reflected upon. The text at hand focuses on the challenges which need to be met by leaders in the field of hospice work and palliative care. In this context, the major milestones in the development of the hospice movement are given - from its beginnings as a voluntary movement, to its increasing institutionalisation and integration into the health care system. Based on the concept of hospice palliative care perceived and unperceived factors are identified and critically reflected upon by the leaders interviewed. In the light of systems-theoretical literature, leadership styles and tasks are discussed in detail. At last, the major challenges which persons in leading positions (have to) deal with in hospice and palliative care are summarized. On the basis of this (empirical) research a list of suggestions for hospice palliative leadership is finally developed. In the context of a reflective subjectivity the authoress furthermore looks back on her research process and links her findings to the major findings of the present study.