Recent catastrophic events and subsequent effects of leadership on afflicted populations demonstrates a need for improvement and increased managerial skill. The problem is catastrophic events create situations unfamiliar to many public health leaders. This manuscript was crafted from a review of 28 articles for the publication date range 1992-2012. Public health leadership in a crisis theorizes the application of four leadership skills: technical skills, interpersonal skills, conceptual skills, and emotional skills. A leader of a public health crisis will have to use these four skills for coordinating, managing, and direction of staff and resources. In addition to leading and managing public health resources, a leader in this role will also have to effectively communicate to the public and the media. This leadership theory connects lines of leadership skill to various stakeholders and collaborators. The importance of this leadership theory is for future public health crisis leaders to gain better understanding of the role of public health leadership in a crisis.