In this article, we propose that types of CEO paternalistic leadership will affect the effectiveness of top management team (TMT) decisions, and that team conflict will play a mediating role in the relationship between CEO paternalistic leadership and decision effectiveness in the Chinese context. Data collected from 108 TMTs in China suggest that dimensions of paternalistic leadership significantly affect decision effectiveness: benevolent and moral leadership positively affect TMT decision effectiveness, but authoritarian leadership has negative effects on TMT decision effectiveness. In addition, cognitive and affective team conflicts partially mediate the links between paternalistic leadership types and decision effectiveness. The results suggest that CEO paternalistic leadership approaches and conflict modes significantly determine TMT decision effectiveness.