This chapter seeks to inform the reader as it relates to strategic decision making and its inherent influence on strategic leadership, offering insights on the implications, barriers, and related outcomes embedded within this multifaceted process. Decision-making is often a key responsibility of a strategic leader, and requires careful thought and facilitation, in order to ensure maximum benefit and outcomes. Specifically, effective strategic decision-making is a multi-dimensional approach that includes collaboration with key stakeholders both internal and external to the organization. The use of strategic decision-making throughout an organization can assist in the establishment of a strategic culture that is cognizant of the impact of focused decision-making, on the direction and needs of the organization.