Historically examining the cultural foundation for traditional leadership within the Blackfoot Confederacy, composed of the Blackfeet (Pikuni or South Piegan) in Montana, USA, and the North Piegan, Blood (Kainai), and Blackfoot (Siksika) in Alberta, Canada, reveals that authority for leadership is grounded in tribal spirituality. This spiritual authority is integrated within traditional and complex structures that organize the social structures of the Blackfeet, a structure of extended family, bands, and societies that all influence leadership. Traditional leadership authority arises through medicine bundle rituals, ceremonial rites, and protocols that exist within the Niitsítapi (Blackfeet people) worldview. Understanding the complex foundations of traditional tribal leadership facilitates future research and understanding of Indigenous leadership, especially when international borders separate tribes.