The effect of first level manager leadership style to performance of associate nurse Investigated using the leadership paradigm of Transformational and transactional. Transformational and transactional leadership first level manager can be influenced by performance of associate nurse. The purpose of this research is to know the influence leadership style transformational and transactional first level manager to increase performance of associate nurse inpatient room in PKU Muhammadiyah Hospital Bantul Yogyakarta. This research was a non-experimental research using cross sectional design. The populations of this research were associate nurses at PKU Muhammadiyah hospital Bantul Yogyakarta. The samples were 43 respondents by using totality sampling technique. Pearson product moment was used to analyze if there were any correlation between transformational, transactional and associate nurse performance. Multiple regressions were used to analyze the dimensions which the most influence. Correlation showed a significant positive relationships berween those first level manager exhibiting a transformational and transactional leadership style with the performance of associate nurse (p=0.004). Correlation between transformational leadership and performance of associate nurse was significant positive (p=0.001), while Correlation between transactional leadership and performance of associate nurse was not significant (0.270). In conclusions, transformational leadership can be increase performance of associate nurse. So, suggestion for any first level manager to practice transformational leadership in their room.