This article examines key leadership issues in community health partnerships. We assert that leadership in a partnership is differentiated from that in a traditional, hierarchical organization in that participation is voluntary and egalitarian and often entails cooperation by organizations with different cultures and agendas. Partnership leaders, accordingly, often lack formal control over members and their actions. Using qualitative analysis of 115 site-visit interviews of participants in four partnerships in the Community Care Networks demonstration program, we identify and discuss five themes of collaborative leadership: systems thinking, vision-based leadership, collateral leadership, power sharing, and process-based leadership. We then discuss the multiple challenges that collaborative leadership faces in a community health partnership.