AIM: To assess the relationship between paradoxical leadership and nurses' positive attitudes towards artificial intelligence in hospital settings through a strengths mindset as a mediator. DESIGN: A cross-sectional survey conducted from January to March 2024. METHODS: The study included 239 nurses from four hospitals in Port Said, Egypt. To measure the study constructs, three well-established scales were utilised: the Paradoxical Leadership Scale, the Strengths Mindset Scale and the Positive Attitudes Towards Artificial Intelligence Scale. Structural equation modelling was applied for data analysis. RESULTS: The analysis revealed a significant positive relationship between nurse managers' paradoxical leadership and nurses' positive attitudes towards artificial intelligence. Additionally, a strengths mindset partially mediated the relationship between paradoxical leadership and nurses' positive attitudes towards artificial intelligence. CONCLUSION: The study findings suggest that developing paradoxical leadership behaviours-such as managing current work processes while simultaneously driving the exploration of new initiatives-among nurse managers can foster a strengths mindset in nurses, which in turn promotes a more positive attitude towards the integration of artificial intelligence in healthcare. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study enhances the understanding of how paradoxical leadership influences nurses' acceptance of artificial intelligence, underscoring the pivotal role of a strengths mindset in this process. IMPACT: This study suggests that healthcare policymakers seeking smoother integration of artificial intelligence technologies among nurses should prioritise leadership development programmes that equip nurse managers with paradoxical leadership skills and implement training initiatives to strengthen nurses' mindsets. REPORTING METHOD: The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.