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In this article regarding leadership as a vascular specialist, we describe how to understand personal strengths and weaknesses as a leader and what resources are available to assist in leadership, particularly in the neurosciences. We discuss how to assemble a team, build its culture, and get the most out of a group in such settings as running a successful meeting and setting goals for the group. We delve into the importance of diversity and setting an inclusive vision for a group so that all feel valued and respected. We explore such difficult topics as how to have difficult conversations with a team or its members, how to align financial goals and mission with the hospital and medical school, and how to lead through a crisis.