BackgroundStudies in Veteran populations have examined disparities in health service use, care quality, outcomes and increased demands for behavioral health. PurposeThe purpose is to describe the development of nursing leadership roles that influenced practice improvements and demonstrated outcomes related to health disparities in a Veterans Affairs (VA) population over a 12-year period. MethodsThe Sundean and colleagues' concept analysis of nurse leadership influence was applied to frame the initiative process and impacts. DiscussionAntecedents and processes that facilitated leadership development included mentorship, disparities expertise, partnerships, consultation, scholarship, dissemination, advocacy, education, and strong coauthor collaboration. Improvements and outcomes included access to services, improved health indicators, tools, workforce, funding, innovations, and nurse investigator studies, consistent with VA priorities and policy related to disparities and equity. Limitations and barriers were addressed. ConclusionThis initiative models’ strategies to increase nurse leadership in health equity and care transformation in health systems and community practices.