Everyone creates influence during their lives. This may be consciously or unconsciously, through communication, actions or behaviours. A person can be influential through who they are or what they do, such as through their creativity, dependency, vulnerability, position and example. A critically important element of creating change, growth and renewal in health service organisations is the need for strong and effective leadership, of which influencing skills are an integral part. Healthcare organisations are complex entities with large numbers of internal and external stakeholders. Strategic influence is an important aspect of the leadership and management of these organisations, as leaders and managers rely on the ability to enhance the effectiveness of those working in all parts and levels of the organisations as well as those outside the organisations in the broader system. Healthcare managers can increase their impact and achievements through understanding and applying influence, and key aspects of healthcare leadership relate to the processes of influence. When they influence to achieve strategic outcomes, leaders and managers work within and across two important areas: transformational change and negotiation. Links between these are important in healthcare leadership and management, as organisational power and personal influence are seen to influence outcomes (Lankshear, Kerr, Spence Laschinger & Wong, 2013). This chapter explores the issues surrounding influence, particularly as it relates to leadership, management and organisations, as well as how a manager and leader can construct and develop influence to strategically affect projects, initiatives, teams, departments, facilities and organisations.