Front-line workers (e.g., nurses and physicians) and leaders frequently perceive the safety culture in their organization differently. This study uses data from AHRQ’s Hospital Survey on Patient Safety Culture (HSOPS) V.1.0 from 2008 - 2017 to compare leadership and front-line workers' perceptions of patient safety culture. With responses from 1,810 hospitals and more than 800,000 individuals identified as leaders or front-line workers, results show that leadership has a consistently more positive perception of patient safety culture, particularly on items related to managers.