This study explores the relationships between perceived organizational support, leader–member exchange, and employee reciprocity in organizations. Using structural equation modeling, the researchers examined how these factors influence employee attitudes and behaviors, specifically organizational commitment, citizenship behavior, and in-role behavior. The findings indicate that perceived organizational support is most strongly associated with organizational commitment, while leader–member exchange is more closely linked to citizenship and in-role behaviors. The study also highlights the importance of differentiating between exchange relationships with the organization and with supervisors, as each may have distinct effects on employee behavior. The study was conducted with 102 subordinates from a regional hospital in the southern United States. Surveys were distributed to 254 nonsupervisory employees, with a response rate of 49%. Supervisors, who had a 93% response rate, completed separate questionnaires for each subordinate in the study. Measures included perceived organizational support, leader–member exchange, organizational commitment, citizenship behavior, and in-role behavior. The results showed that perceived organizational support was positively related to organizational commitment, while leader–member exchange was associated with citizenship and in-role behaviors. However, perceived organizational support was not significantly related to in-role behaviors. The study contributes to the understanding of social exchange theory by demonstrating that different exchange relationships can have distinct effects on employee attitudes and behaviors. It also highlights the importance of considering the context of exchange relationships, such as the hierarchical structure of the organization, when interpreting the effects of these relationships on employee behavior. The findings suggest that organizations should recognize and support multiple exchange relationships to foster positive employee attitudes and behaviors. The study also notes the limitations of nonexperimental designs in establishing causality and the potential for bias in self-reported data. Overall, the study provides valuable insights into the complex relationships between social exchange, employee behavior, and organizational outcomes.This study explores the relationships between perceived organizational support, leader–member exchange, and employee reciprocity in organizations. Using structural equation modeling, the researchers examined how these factors influence employee attitudes and behaviors, specifically organizational commitment, citizenship behavior, and in-role behavior. The findings indicate that perceived organizational support is most strongly associated with organizational commitment, while leader–member exchange is more closely linked to citizenship and in-role behaviors. The study also highlights the importance of differentiating between exchange relationships with the organization and with supervisors, as each may have distinct effects on employee behavior. The study was conducted with 102 subordinates from a regional hospital in the southern United States. Surveys were distributed to 254 nonsupervisory employees, with a response rate of 49%. Supervisors, who had a 93% response rate, completed separate questionnaires for each subordinate in the study. Measures included perceived organizational support, leader–member exchange, organizational commitment, citizenship behavior, and in-role behavior. The results showed that perceived organizational support was positively related to organizational commitment, while leader–member exchange was associated with citizenship and in-role behaviors. However, perceived organizational support was not significantly related to in-role behaviors. The study contributes to the understanding of social exchange theory by demonstrating that different exchange relationships can have distinct effects on employee attitudes and behaviors. It also highlights the importance of considering the context of exchange relationships, such as the hierarchical structure of the organization, when interpreting the effects of these relationships on employee behavior. The findings suggest that organizations should recognize and support multiple exchange relationships to foster positive employee attitudes and behaviors. The study also notes the limitations of nonexperimental designs in establishing causality and the potential for bias in self-reported data. Overall, the study provides valuable insights into the complex relationships between social exchange, employee behavior, and organizational outcomes.