Aim To capture and interpret meanings of suffering from the perspective of perioperative nurse leaders.Background There are few studies focusing on suffering and the meaning of being a nurse leader in a perioperative context.Method Hermeneutic interpretation of interviews with nurse leaders.Results A main theme of suffering emerged as learning and non-learning. Suffering as learning comprised struggling to come to terms with being misunderstood, struggling to wait patiently to be allowed to help, struggling to manage daily tasks and struggling to be worthy of the trust of superiors. Suffering as non-learning comprised feeling alone when in charge, feeling guilty about not managing dailytasks, feeling mistrusted by superiors, feeling unfairly criticized,  feeling humiliated owing to loss of responsibilities and feeling unable to help. Conclusion Suffering is good when the mission of caring is mastered and the nurse leader feels recognized as unique and trustable, leading to his or her sense of dignity being preserved. Suffering is evil when the mission of caring is threatened, whenquestioned and not considered a unique and trustable person, leading to loss of dignity.Implications for nursing management Nurse leaders suffering needs to be acknowledged and a caring culture that permeates the entire organization should be developed.