Emergency medical teams operate under unusual circumstances. They assemble for a singular, temporary purpose, potentially change in size and composition, and their performance can influence whether a patient lives or dies. Although leadership is a critical component to team success, it is rarely investigated in the context of emergency medical teams. This study sought to examine the relationship between directive leadership behaviors and team performance outcomes. It was hypothesized that directive leadership would be particularly effective for emergency medical teams. In addition, a contingency model was proposed. Specifically, it was hypothesized that the effectiveness of directive leadership is contingent upon the complexity of the situation and the experience level of the team such that directive leadership is more effective when teams are inexperienced and the situation is complex. Neonatal resuscitation teams served as the emergency medical teams in this study. The proposed relationships were tested using observations from high-fidelity, neonatal resuscitation team training simulations. Hypotheses were not supported. Limitations and suggestions for future research for the development of leadership training curriculum are discussed.