Leadership skills can be critical in emergency medicine. However, there are no works that analyze this issue in much more details.To analyze the level of leadership skills in emergency medicine students, and also checking if despondency perfectionism is a variable that reduce the correlation between self-efficacy and leadership skills.The analyzed group consisted of 75.76% of all emergency medicine students taking up education at the Medical University of Warsaw in 2018 (n = 150, W = 74, M = 71). The average age was 23 years (SD = 1.7). All students were divided into two groups: Group 0 - without maladaptive perfectionism (n = 64), and group 1- with maladaptive perfectionism (n = 79). In the cross-sectional study, three standardized research tools were used: Authentic Leadership Questionnaire, Almost Perfect Scale-Revised (APS-R), and General Self-Efficacy Scale (GSES). ANCOVA analysis was used.The linear regression coefficients for both comparison groups were significantly different (interaction of variables: “maladaptive perfectionism * self-efficacy”: F = 4.841, p = .029). Comparing adjusted mean values for both groups (0 vs 1), it can be stated that students from group 0 had a significantly higher level of authentic leadership skills compared to group 1 (F = 4.432, p = .037).Studies to determine the mechanisms of a positive relationship between the self-efficacy and leadership skills in emergency medicine students with high maladaptive perfectionism are required. This will allow the development of effective programs to strengthen the leadership skills of these students.