Organizations can be led and managed in many different ways and there is no shortage of perspectives, models, and frameworks for thinking about how such tasks can be accomplished. This chapter focuses on one such perspective: evidence-based management (EBMgt). It starts with an account of the origins of the idea of evidence-based practice in other fields and how it has been adapted in the development of EBMgt. The chapter then looks at the sometimes controversial notion of leadership and what we know about what managers and leaders do. It then considers the extent to which leaders, managers, and organizations are evidence-based in their approach to managing organizations and what can be done to further develop this approach. Finally, the chapter discusses some of the challenges that managing in an evidence-based way present to leaders and to more traditional ways of thinking about what leadership entails.