Abstract
Background/Objectives: Ethical leadership (EL) propels and enhances employee performance (EP), especially in healthcare, where ethics are paramount. However, existing research lacks a focus on how EL functions within Saudi Arabia (SA)'s public healthcare context. Primarily, this research investigates how EL directly affects EP. The research also investigates how organizational support (OS) influences EP and moderates the EL-to-EP relationship. Methods: This cross-sectional study consisted of 312 responses from doctors, nurses, and other administrators within Saudi public healthcare units. To analyze the collected data statistically, structural equation modeling (SEM) was opted for with the help of Smart-PLS 4. It helped to assess the direct effects of EL and OS on EP and further examine OS's moderating role. A multigroup analysis (MGA) was also conducted in comparative form. It examined subgroup variations across gender, age, marital status, experience, and departmental affiliation. Results: The findings confirmed a positive impact of EL on EP. Moreover, a positive effect of OS on EP was also confirmed. Similarly, OS strengthened the positive effect of EL on EP. The MGA revealed variations across employee groups. It offered practical insights into how EL and OS function in diverse organizational contexts. These differences across groups reflect cultural and structural features of Saudi public healthcare. Conclusions: The extended research contributes to the literature on ethical leadership (EL) theory by applying contextual and demographic contingencies within the Saudi public healthcare sector. It also introduces OS as a significant moderator and provides actionable implications for improving performance through context-sensitive leadership and support strategies.