Objective To explore the mediating effect of leader-member exchange (LMX) between the transformational leadership and error management climate, so as to provide reference for clinical nursing management. Methods A total of 877 nurses from 4 grade three hospitals in Tangshan were selected using convenient sampling, then they were investigated using the general information questionnaire, the Transformational Leadership Scale, the Leader-Member Exchange Scale and the Error Management Climate scale. Results The total score of transformational leadership was (94.57±16.68) , which was (56.02±11.67) for LMX and (60.94±12.15) for error management climate. Transformational leadership was positively correlated with the error management climate and LMX, and LMX was positively correlated with the error management climate (P＜0.01 for all). The indirect effect of transformational leadership on the error management climate was established, and the indirect effect was 0.134. And 25.52% effect of transformational leadership on the error management climate was realized through LMX. Conclusion Transformational leadership can enhance the LMX between head nurse and nurse, thus improving the error management climate.