Effective leadership in the field of dietetics is becoming increasingly vital in a rapidly changing world. A determination of factors which impact leaders and their followers is essential. This study was designed to examine the relationship between religiosity and spirituality and transformational leadership characteristics of hospital food and nutrition managers as rated by self as well as by those directly supervised by the managers. The influence of religious and spiritual beliefs on the workplace and workplace practices was also examined. Respondents were selected from the American Hospital Association database. Hospitals from 250 to 499 beds were included. Directors of Foodservice and Nutrition Services as well as Clinical Nutrition Managers were asked to participate, along with those they directly supervise. Of managers who initially agreed to participate, 129 (72%) were included in the final analysis, along with 530 of their subordinates. Variables examined included the influence of religiosity/ spirituality on the workplace and workplace actions of respondents, issues relating to trust, self- and employee-rated transformational characteristics of managers, demographics, job related factors, and religiosity and spirituality of managers and employees. Frequency data was collected for virtually all questions on the survey instrument. General Linear Model (GLM), Pearson's Correlation, and the Means Procedure were all used as appropriate to examine the relationships between the variables of interest. The religiosity and spirituality of managers and their employees were not related to perceived transformational leadership characteristics of managers. Both managers and employees with higher levels of religiosity and spirituality were more influenced by (and demonstrated through their actions) religious and spiritual beliefs in the workplace. Transformational leadership was related to other variables examined, such as the type of manager, job enjoyment of managers and employees, as well as issues relating to trust between managers and employees. There were also significant differences seen between manager perceptions of their transformational leadership characteristics and employee perceptions of their managers. Managers rated themselves consistently higher on all individual Transformational Leadership Scales, as well as the summed Transformational Leadership Score, than did their employees. These differences were all highly significant based on the Means Procedure.