The subject of this article is the role of spirituality in diaconal work. This raises two questions: first, what do we mean by spirituality, and second, what characterises the field of diaconia and diaconal practice? To begin with, a few conceptual clarifications are necessary. C. Otto Scharmer’s Theory U (TU) provides the conceptual and methodological framework for operationalising spirituality in diaconal work. It is argued that the concept of “presencing” is an adequate way to express “spirituality”, and that, overall TU is an appropriate model to describe and develop the essential features of diaconal social work and diaconal leadership. I shall use the Danish Blue Cross as an example of an organisation that can be interpreted as working on the basis of TU.