This chapter presents the findings from a qualitative study of the challenges of brand leadership in a public sector context. Based on 27 interviews with directors of communications in Norwegian public hospitals, we demonstrate how the brand leadership philosophy in this context involves balancing branding techniques with a universalistic public service ethos. While brand leadership normally implies attempts to stand out as unique organizations, the particular context of the hospital sector makes it more important for the hospitals to demonstrate that they are part of a big family of hospitals.