Understanding nurse leader fatigue and its relationship with turnover intention is essential for maintaining a viable leadership workforce. This secondary analysis of a national survey of nurse leaders explored the relationships of organizational and individual factors with nurse leader fatigue and turnover intention. A nurse leader's membership in individual and organizational classes is associated with differences in acute and chronic fatigue levels. There were significant relationships between acute and chronic fatigue states and turnover intention. Acute fatigue was a mediating factor between individual and organizational classes and turnover intention. Future interventions to decrease nurse leader turnover intention could be tailored for different types of organizations, individual classes and fatigue type.