Leaders regularly experience identity threats that are potentially harmful to the enactment of their self-identity as leaders. Yet research into leader identity threat, particularly those that examine the lived experience of individual leaders in situ, is scarce. Drawing on social constructionism and identity discrepancy theories, we explore the leader identity threat experienced by emergency physicians whose leadership practice is characterized by a paradoxical tension between the institutionally obligated leader identity and a more personal, idealized servant identity. On the basis of Interpretative Phenomenological Analysis (IPA) of interview data obtained from 10 emergency doctors across Australia and New Zealand, we found that the experience of incongruous multiple selves at different levels (i.e., intrapersonal, interpersonal, intra-organizational) translates to a process of encountering, appraising, and strategizing in response to leader identity threat. Our study findings contribute to a deeper understanding of the complexities of leader identity threat, the tensions between professional obligations of leadership and vocational ideals of service in high-pressure and dynamic team context, and the effects of identity threat on leaders' well-being and careers. Theoretical contributions and practical implications are discussed at the conclusion of the paper.