Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers.MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences regarding facilitating MCD's implementation have not yet been studied.As part of an empirical qualitative study on implementing MCD in mental health care, a responsive evaluation design was used. Using former research findings (iterative procedures), a managers' focus group was organised.Managers appreciated MCD, fostering nurses' empowerment and critical reflection - according to managers, professional core competences. Managers found MCD a challenging intervention, resulting in dilemmas due to MCD's confidential and egalitarian nature. Managers value MCD's process-related outcomes, yet these are difficult to control/regulate.MCD urges managers to reflect on their role and (hierarchical) position both within MCD and in the nursing team.MCD is in line with transformative and participatory management, fostering dialogical interaction between management and nursing team.