Background Amid the complexities of a healthcare system facing economic collapse, pandemic challenges, a devastating human-made disaster, and critical staffing shortages, effective leadership becomes paramount. This article explores the adaptive leadership approach in the face of unprecedented challenges, drawing from the experiences of a healthcare system in Lebanon. Methods Anchored in Maslow's hierarchy of needs and guided by the adaptive leadership framework, leaders addressed challenges resulting from the economic crisis, compounded by the COVID-19 pandemic and a catastrophic explosion in Beirut, which tested the resilience of the healthcare system. Results Challenges ranged from resource shortages and financial strain to the critical staffing upheaval and psychological impact on healthcare workers. Prioritising physiological, safety, belongingness, self-esteem and self-actualisation needs, leaders implemented innovative strategies, including volunteer mobilisation, recruitment plans, makeshift clinics and psychological support. Transparent communication, self-esteem recognition and fostering resilience emerged as crucial components. Conclusion The article provides insights into the practical application of adaptive leadership and Maslow's hierarchy of needs in navigating multifaceted crises within a healthcare setting. It underscores the significance of fostering resilience, prioritising the well-being of healthcare professionals and leveraging innovative solutions to ensure the continued delivery of high-quality care amid unprecedented challenges.