Background and aims: Bullying at work can be considered one of the main factors of stress in the work environment, which has adverse consequences. Bullying behavior can have a negatively impact on the quality of services and patient satisfaction. The aim of the present study was to determine organizational bullying behavior based on social exchange styles in pre-hospital emergency personnel of Ardabil province. Methods: The current cross-sectional descriptive study was conducted with the statistical population of 357 personnel working in the pre-hospital emergency department of Ardabil province. The sampling method was a census. Data collection tools included Inarsen's organizational bullying assessment standard questionnaire and Liebman's social exchange style questionnaire. The data were analyzed with spss software version 22 and descriptive and inferential statistical methods at a significance level of 0.05. Descriptive statistics were used to determine frequency, count, percentage, mean, and standard deviation. Inferential statistics were also utilized to determine the relationship between demographic variables and bullying, as well as the social exchange style, using independent t-tests and correlation coefficients based on the type of variables. To examine the simultaneous effect of each variable influencing bullying, linear regression analysis was conducted Results: There was a statistically significant relationship between bullying and work experience (p=0.03), education (p=0.04), job satisfaction (p=0.03) and overtime hours (p=0.04). There was a statistically significant relationship between social exchange style and work shift (p=0.02), work history (p=0.02), age (p=0.04), and job satisfaction (p<0.001).The mean and standard deviation of work-related bullying, personal bullying and physical bullying were 20.75±2.53, 21.81±3.05 and 5.27±1.57, respectively. The results showed that there is a significant relationship between bullying and extreme investment styles (p=0.03) and fairness (p=0.02). Conclusion: Social exchange style of fairness and variables of work experience, education and job satisfaction are predictors of bullying behavior and can be effective in better understanding of bullying and correct management and prevention of bullying behavior in the workplace. Managers can utilize social exchange styles in their interactions in clinical environments and identify bullying behaviors in work environments to improve their behavior and improve the quality of services.