Purpose – Some underlying mechanisms regarding presenteeism still remain unclear, namely, the construct of “presenteeism climate” and the importance of “leadership” Leader-Member Exchange (LMX) for presenteeism. In order to shed some light into this phenomenon, the purpose of this paper is to develop and apply a new scale of presenteeism climate. Design/methodology/approach – In Study 1, the authors identified a pool of items from the literature and, in Study 2 (n=147) the authors tested 26 items that were pilot studied with exploratory factor analysis. In Study 3 (n=293) the authors tested a three-factor model – extra-time valuation, supervision distrust and co-workers competitiveness – with confirmatory factor analysis. Findings – Results showed that LMX has a negative correlation with presenteeism climate. Study 3 also showed that this structure remained invariant with additional samples from employees working in hospitals from Ecuador (n=90) and China (n=237). Finally, the authors included suggestions for future studies to overcome the limitations of this research. Practical implications – This study has implications for managers and academics, as it emphasizes the importance of favorable behaviors between leaders and employees in order to decrease presenteeism and its adverse consequences. Originality/value – The main contribution consists of identifying dimensions of presenteeism climate and developing measures. Additionally, the authors contribute to the literature on leadership by studying the influence of LMX on presenteeism climate.