Very limited attention has been given by scholars to the relationship between servant leadership and employee behaviors in the public sector and not much is known about the mechanisms through which this relationship may take place. This study examines the relationship between servant leadership and proactive behaviors in the Egyptian public health sector and investigates the role of leader–member exchange (LMX) as a mediator. Using a sample of Egyptian public hospital nurses, the results of structural equation modeling (SEM) indicate that servant leadership was positively related to LMX which, in turn, had a significant positive association with proactive behavior. Thus, servant leaders encourage employees to engage in proactive behavior through enhancing the quality of their exchange relationship with their supervisors.