Conduction system pacing (CSP), including His bundle pacing (HBP) and left bundle branch area pacing (LBBAP), is a growing alternative to traditional right ventricular or biventricular pacing. The choice between stylet-driven leads (SDLs) and non-stylet-driven leads (NSDLs) remains operator-dependent, with limited comparative data. To compare characteristics and outcomes of SDLs and NSDLs for CSP using data from the National Cardiovascular Data Registry (NCDR). We analyzed 11,412 CSP implantations from April 2021 to December 2023 in the NCDR Electrophysiology Device Implant Registry. A descriptive analysis of baseline and procedural characteristics, as well as crude in-hospital outcomes, was conducted between the study groups. Additionally, in-hospital outcomes were assessed using multivariable logistic regression, accounting for the patient and hospital-level covariates. NSDLs (87.7%, n=10005) were the predominant lead type, though SDL (12.3%, n=1407) use increased significantly over time. Compared with NSDL recipients, patients receiving SDLs had higher rates of heart failure (61.6% vs. 48.6%; p<0.001) and lower LVEF (42.3% vs. 47.4%; p<0.001). Implant success was slightly higher with SDLs (98.4% vs. 96.2%; p<0.001). Overall complication rates were low and similar (2.8% vs. 2.1%; p=0.089), with no statistical differences in perforation, lead dislodgement, or mortality. Lead type was not associated with increased odds of complications or prolonged hospitalization. In this large national cohort, both SDL and NSDL leads achieved high implant success with low complication rates. These findings support the safety and effectiveness of either lead type and suggest selection may be guided by operator preference.