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This is part of a case series. The case 'Leading a University in the Midst of a Pandemic' has two parts: (A) Difficult Decisions; (B) A Fruitful Dialogue. The case follows the Rector of the University of Bologna, Professor Francesco Ubertini, as he copes with the first wave of COVID-19 outbreak in Italy. In Case (A), the Rector grapples with the first terrible weeks following the arrival of COVID-19 in Northern Italy at the end of February 2020. At the same time, he needed to make several important strategic decisions in order to ensure business continuity and the safety of 87,000 students and 5,000 faculty and staff members who constituted the community of the University of Bologna, a so-called mega-university with 5 campuses across the Emilia Romagna Region that offer 220 graduate, postgraduate and PhD courses. Case (A) focuses on what are the most appropriate leadership skills that can enable the Rector to cope with this huge crisis. It also addresses some advantages that agile methodologies can provide to large bureaucratic organizations, likewise a public University.