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From its inception, Hadassah created a new version of American Zionism, both ideologically and practically. It was women’s Zionism, or at least another kind of American Zionism. Hadassah’s ideology emerged from two major influences: the ideas of its founders, particularly Szold’s Zionism and feminist assumptions, and the ideas of American Zionist leaders and thinkers, mainly Louis Brandeis, who formulated the leading principles of American Zionism, and Rabbi Mordecai Kaplan’s Zionist notions.   

Hadassah’s founders’ most basic organizational assumption was separatism from Zionist men. The premise of the organization's founders and their successors was that women should be organized and operate apart from men within female-only organizations. In accordance with contemporary social feminist views, Hadassah’s founders also believed women were more qualified for practical work than for ideas and ideologies. They concluded that, with respect to Zionist work, men were more qualified to deal with the political sides of nation-building, while women were better qualified to work in the traditionally female spheres of education and health. The founders believed that women and men could make equal contributions to Zionist goals but in different areas. 

Hadassah’s founders also believed that in order to create and maintain a women’s organization, members should be motivated by specific concrete projects. As early as 1913, Szold argued that the key to energizing Hadassah was basing it on a long-term activity of "practical philanthropy that occupies itself with the needs of women and children [because it] …makes an appeal to all American women." Szold’s idea was building the Land of Israel in women's way, i.e. through practical projects. As a result, "doing" became the major characteristic of Hadassah's ideology and practice for years to come.

Hadassah’s founders thus focused from the beginning on long-term projects. They chose projects that gave women a role in the American as well as world Zionist movements, had special appeal for women but did not challenge gender norms in the Jewish or American society, and did not compete with men.

Although from its inception Hadassah has always worked to give women a distinct place in Zionism, it generally did not strive to promote women’s status or welfare only, neither in the United States nor in Palestine. Moreover, although its initial project was aimed at helping children, its major work in the Yishuv was medical, so its activities specifically on behalf of women gradually decreased. None of its constitutions or major documents include explicitly feminist aims. An exception was its active support for Yishuv women’s suffrage and equality in the Mandatory period.

The Zionist orientation of Hadassah's founders differed from that of the male Zionist leaders, who criticized Hadassah for not engaging in work designed to change Jews into a self-conscious political entity. Hadassah, they claimed, merely engaged in charitable endeavors to improve living conditions in the Yishuv. In fact, Hadassah’s decision to establish an urban nurses’ settlement ran counter to Zionist emphasis on cooperative rural settlements and European Zionist methods of colonization. In its early days and some of its later health work, Hadassah stressed woman-to-woman work and work for children on humanitarian grounds, as well as on American social feminist ideology.

Hadassah’s Zionism was a form of practical idealism that Szold considered characteristically Jewish. “Zionism as we dreamed it in America,” Sampter wrote in 1921, “was the dream of a regenerate humanity.” Hadassah also avoided religious controversy: The only two holidays it celebrated were Purim and Hanukkah. Hadassah urged its members to express their Jewish identification through work for Palestine. As Hadassah’s first president from 1912 to 1921, Szold wanted to mold “a compact, self-reliant organization … to foster solidarity, to weld thousands of women scattered all over the country into a homogeneous group.” Hadassah actively recruited non-Zionist women as well. It resisted efforts to decentralize and established an administration fund—a novelty in Jewish organizational circles—to cover costs of its central administration.  

Hadassah’s brand of Zionism was heavily influenced by Louis D. Brandeis' claim that every American Jew must become a Zionist and that American, Zionist, and Jewish identities were complementary. Hadassah aspired to be a broad Zionist movement that would include every American Jewish woman. Its Zionism was greatly infused with Americanism and American patriotism, and it adhered to the American ethos and commitment to democratic ideals.  

Hadassah's admiration of American science, technology, and professionalism, especially in its medical activities in Palestine, reflected its American patriotism. The history of Hadassah's enterprises in the Yishuv and Israel is the history of importing American models in medicine, welfare, and vocational education and reflects Hadassah's threefold identity as female, American, and Zionist: American since these were "American-born" projects, Zionist as it was aimed at the Yishuv, and female because the projects were appropriate for women.

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In 1920 the Hadassah national convention adopted a resolution to create the Junior Hadassah, for girls eighteen to 21. The young women immediately adopted the care of war orphans in the Yishuv. Szold suggested their motto: “A joyful mother of children.” By 1923, Junior Hadassah had its own leaders. Frieda Silbert of Boston served as its first chair, and Mignon Levin Rubenovitz, a graduate of Columbia University’s Teachers College and early Hadassah member, was senior adviser.

Hadassah also helped establish the American Zionist Youth Commission in 1940, directed by Shlomo Bardin. Its leadership training programs proved quite successful both for Young Judaea and Junior Hadassah and paved the way for Hadassah supervision of the former.

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A few days after the beginning of World War II, Hadassah and the ZOA founded the Emergency Committee for Zionist Affairs, which was eventually made up of the four major American Zionist organizations; Hadassah was the only women's Zionist organization to take part. In 1941 Hadassah had five representatives on the Committee, the same number as the ZOA, allowing it to take part in the formation of the American Zionist movement's policy.

Hadassah was also active in helping the American war effort. By February 1942, about two months after the United States entered the war, it had pledged full support for the United States war effort. One of the most prominent manifestations of this commitment was the raising of over $200,000,000 in war bonds. In 1942 Hadassah was the fifth largest contributor to the American war effort.

For a variety of reasons, when information about the mass murder of European Jews arrived in America in 1942, Hadassah "buried" the information in the back of its bulletin and scarcely dealt with it in the internal sessions of its national board. Prominent among those reasons was the leadership's fear that members would leave the organization, resulting in great damage. The leadership also saw Hadassah's role as saving Jewish children, not all of European Jewry. Its leadership and members made an enormous effort on behalf of Youth Aliyah, beginning in 1935 through the end of the war and after. Hadassah, then, saw its role during the Holocaust as focused on rescuing children and youth.

In the late 1930s, Hadassah began to forge an independent political path in the Zionist movement, crossing an important gender boundary. The major figure to push for political activity was Rose Jacobs. In 1937, Hadassah ran its own slate of eighteen delegates to the WZO Congress and started efforts to gain responsibility and political influence within the broader Zionist movement. In the 1940s it took on a central role in the World Zionist Movement's institutions and reached the highest levels of its administration, attempting to influence Zionist policy in several areas, especially Arab-Jewish relations.

From the 1920s through the early 1940s, Hadassah saw Jewish-Arab relations in Palestine through the lens of cultural pluralism. Many Hadassah leaders believed Jews and Arabs in Palestine could and must live side by side in peace. This view corresponded with feminist beliefs in the post-World War I period that women, unlike men, had the ability to heal the world.  

Many Hadassah leaders thus saw their mission not only as nurturing a healthy population but also as healing of what threatened to divide the two peoples. Hadassah leaders, headed by Rose Jacobs, Tamar De Sola Pool, and others, aspired to shape Zionist policy with respect to Jewish-Arab relations. Rose Jacobs was chosen to head a Hadassah committee on Jewish-Arab relations and became its driving force. The committee sought a solution that would enable the continued development of a Jewish national home with the agreement of Palestinian Arabs. Jacobs clashed with Ben-Gurion more than once, against the background of the committee's authorities, and Ben-Gurion even doubted if the committee should exist at all.  

In November 1941, Hadassah declared its support for establishing a Jewish Commonwealth in Palestine; two months later it supported the 1942 Biltmore Program, which made political demands per se:  the establishment of a Jewish Commonwealth in Palestine, the abolishment of the 1939 White Paper that limited and sought to "nullify Jewish rights to immigration and settlement in Palestine," and the founding of "a Jewish military force fighting under its own flag and under the high command of the United Nations." Hadassah’s support of the Biltmore Program was understood within the Zionist arena as a transformation of Hadassah's traditional policy. The Arab-Jewish committee headed by Jacobs was disbanded in 1943, against the backdrop of disagreements, particularly on the matter of the binational state.  

In the aftermath of the war, Hadassah's membership and its power in the World Zionist Organization increased. Representing Hadassah, Judith Epstein, Hadassah national president at the time, testified before the Anglo-American Board of Inquiry in 1946 to get the British to open Palestine to Jewish refugees. In 1947 Hadassah leaders and members lobbied the American government to support the partition plan (partition of the British-ruled Palestine Mandate into separate Jewish and Arab states). Although Hadassah was a partner in the American Zionist movement’s efforts to establish a Jewish state, however, the leading force was the male-led Zionist Organization of America.

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During the 1950s and 1960s, Hadassah made great political efforts on behalf of Israel, aiming to secure American foreign aid and to encourage the United States government to supply weapons to Israel and to prevent arms supplies to Arab countries. In lobbying for these goals, Hadassah used language aligned with American cold war rhetoric that portrayed conflicts in the Middle East as part of the struggle between the forces of Americanism against Communism; it also appealed to American Jews’ patriotic state of mind at the time. Its central argument was that Israel was the stronghold of democracy and anti-communism in the Middle East, a region increasingly dominated by the Soviets. In the 1960s, Hadassah added the aim of preventing American businessmen from surrendering to the Arab boycott.

The lobbying attempts were intensified after the 1967 Six Day War, against the background of international attempts to present Israel as aggressive and responsible for the Palestinian refugee problem. The problem had existed before but worsened as a result of the war. Hadassah stood for Israel and stressed that the Arab states did not take responsibility for the refugees within their borders, and that the United Nations contributes to the continued existence of the problem by providing assistance through the United Nations Relief and Rehabilitation Administration (UNRRA), rather than helping the refugees assimilate within their host countries.  

Those messages were also delivered among others to Hadassah members who were recruited as lobbyists to convince American public opinion. Hadassah’s national office prepared background information to present the Israeli position; members were asked to disseminate this information in public libraries and Jewish communities all over the United States.

In the 1950s and 1960s, Hadassah also took part in significant domestic American political activity. Hadassah came out against McCarthyism, which it saw as a serious threat to the democratic character of America and a grave challenge to its own deeply held liberal convictions. It strongly supported desegregation and the civil rights movement. It encouraged its members to vote in local and national elections, in some cases revolving around civil rights issues. During the 1960s, Hadassah continued to advocate for civil rights legislation and efforts to desegregate the South. In its 1963 convention, it passed a resolution backing the Civil Rights Bill and encouraging its members to lobby their local politicians to vote for the legislation. Into the late 1960s, Hadassah continued to urge civil rights legislation and associate the organization with what it considered the moderate wing of the Black community.

When the Conference of Presidents of Major American Organizations was organized in 1956, Hadassah became a constituent member. In 1968, Hadassah subscribed to the Jerusalem Program of the World Zionist Congress, including the "unity of the Jewish people and the centrality of Israel, the ingathering of Jews in their historic homeland, strengthening the State of Israel, preserving Jewish identity through education, and protecting Jewish rights everywhere". In 1970, Hadassah was a founding member of the reorganized American Zionist Federation. 

Hadassah has a seat on the executive of the Jewish Agency for Israel and the Zionist General Council. It is also accredited with the United Nations as a nongovernmental organization.

Finally, during the 1960s and the 1970s Hadassah was active in the struggle for Soviet Jewry. It galvanized American public opinion to press the Soviet government to cease offenses against Soviet Jews’ spiritual and cultural life and enable them to emigrate.

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