Leadership’ as a key component of organisational success has become a focus of increased attention for academics and policy makers. Leadership theory, strategy, training, styles and development are prominent themes in the business world. Major investments in time and money are made each year to cultivate these traits and skills in people across the globe. In more recent years, these themes have been transferred into healthcare systems and into healthcare practice. Reviews of leadership within the professions of nursing and medicine have been conducted but this has yet to be undertaken in the field of physical therapy. The aim of this opinion piece is to discuss the current situation regarding leadership and leadership development in physical therapy internationally. It reports on what physical therapy organisations are doing to promote leadership and leadership development programmes in the profession. Leadership education and styles, as well as the barriers and factors affecting leadership in physical therapy today, and the evidence behind these, are also explored.