Educational hospitals operate in a dynamic and complex environment that necessitates a transition from traditional management approaches to agile and innovative strategies. This study aimed to investigate the relationship between the four components of transformational leadership and economic innovative behaviors among managers of educational hospitals in Iran. The research employed a descriptive-correlational design based on structural equation modeling. The statistical population comprised senior and middle managers of educational hospitals affiliated with medical universities across the country in 2024. Using Cochran's formula, a sample of 217 participants was selected through stratified random sampling. Data collection instruments included the standard Multifactor Leadership Questionnaire (Bass & Avolio) and a researcher-developed questionnaire measuring economic innovative behaviors, both of which demonstrated confirmed validity and reliability. Data analysis was conducted using SmartPLS 4 software and bootstrapping algorithms. Findings revealed that all components of transformational leadership exerted positive and significant effects on economic innovative behaviors .Intellectual stimulation demonstrated the strongest direct effect, while individualized consideration showed the weakest direct effect. The structural model of the study explained 68.4% of the variance in economic innovative behaviors, indicating strong explanatory power. The results suggest that enhancing transformational leadership competencies, particularly in cognitive and motivational dimensions, provides the necessary foundation for fostering economic innovative behaviors.