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In this review, we develop a framework to guide future research and to examine the execution of leadership in extreme contexts. We start by defining and distinguishing extreme contexts from crisis and other contexts. A five component typology is developed comprised of magnitude of consequences, form of threat, probability of consequences, location in time and physical or psychological–social proximity. We discuss the unique influences these components have on leadership processes in extreme contexts examining the relevance of organization types such as critical action and high reliability organizations. Further, we present a set of factors that may attenuate or intensify the dimensions comprising an extreme context, thus influencing either a team or organization's ability for adaptive leadership response. Ultimately this framework seeks to develop a richer understanding of extreme contexts to advance the future development of contextualized theories of leadership for extreme contexts.