Taking a more holistic view that incorporates both the benefits of female chief executive officers (CEOs) and the stereotype biases faced by them, this study integrates upper echelons theory with theories of social role and role congruity to uncover a unique dilemma faced by female CEOs in the context of workplace safety. On the one hand, drawing upon the behavioral differences perspective of female leadership derived from social role theory, we argue that female CEOs are more attentive to the health and safety of their employees, resulting in fewer workplace injuries. On the other hand, based on role congruity theory, we argue that female CEOs suffer from the bias in leader evaluations when there are organizational health and safety related issues, leading to more employee external whistleblowing. Further, we argue that the effect of female CEOs on the reduction in workplace injuries is accentuated, but on employee external whistleblowing is attenuated, when the CEO has a longer tenure. Analyzing a sample of 33,913 establishment-year observations from 694 unique firms, we found support for the predictions. Our research contributes to the strategic leadership literature by integrating two prevailing accounts of female leadership in the context of workplace safety and revealing significant challenges facing female CEOs.