Purpose The purpose of this paper is to investigate how, and the degree to which, superior and peer managers exerted pressure on middle managers' work cross-culturally. Design-methodology-approach Australian ( n=251) and Singaporean ( n=340) health managers, respectively of Anglo and Confucian-Asian cultures, rated the pressures exerted on them by managers, superior and peer (managers at the same level), regarding nine work pursuits, and described the nature of this pressure. Findings Singaporeans reported greater pressure from superiors regarding people, customer, process and quality management. Australians and Singaporeans experienced similar pressure from superiors concerning financial, organisational, data, planning and external relations management. Singaporeans reported more pressure from peers in all work domains. In Singapore superior and peer managers applied pressure to similar activities but areas targeted by Australian peer and superior managers were not significantly related. Singaporean superiors were more likely to apply pressure through deadlines and appraisals. Research-limitations-implications Convenience samples from one occupational sector may limit the generalisability of the results. Practical implications Knowledge of the degree and sources of stress encountered by middle managers in an Anglo and a Confucian-Asian culture may enhance organisational communication both within and between these cultures. Originality-value Although it is a crucial issue, pressures exerted on managers by superior and particularly peer managers regarding specific managerial work pursuits has received little attention, particularly from a cross-cultural perspective.