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Broad access to healthcare services is a key factor of human development in any country. The current health care situation in South Africa can be diagnosed as critical. The hospitals are understaffed, over-occupied and the diseases like Human Immunodeficiency Virus (HIV) give health care workers additional challenges. The demand for management skills in the health sector including those for nurse managers is high. A recent World Health Organization (WHO) study of nurses working in maternal health services identified good management as more important than salary, unless the remuneration was dramatically higher. In South Africa, little empirical research exists about the management skills of nurse managers, even though proper management of human resources is vital to achieve better outcomes and access to health care around the world. The object of this research project was to identify the gaps between required and existing management skills of senior nurse managers in South Africa in private and public hospitals. Once identified, this skills gap assessment can be used by employers and policy-makers to define the management education that nurse managers require.