Transformational leaders challenge the status quo, provide a vision of a promising future, and motivate and inspire their followers to join in the pursuit of a better world. But many of these leaders also fit the American Psychiatric Association classification for narcissistic personality disorder. They are grandiose, entitled, self-confident, risk seeking, manipulative, and hostile. This article reviews the literature on narcissism and shows how what we think of as transformational leadership overlaps substantially with grandiose narcissism. As grandiose narcissists can appear as transformational leaders, it is important to distinguish between what leadership scholars have characterized as “transformational” and these “pseudo-transformational” candidates.