Small and medium-sized enterprises (SMEs) account for 92% of all Ghana firms, providing 60% of citizens' employment and contributing about 70% of Ghana's income from gross domestic products. Within the first 5 years of operation, 40% of new businesses fail. The purpose of this multiple case study was to explore strategies used by Ghanaian SME manufacturing leaders in the fruit industry to sustain business for longer than 5 years of operation. The conceptual framework for this study was open systems theory and complexity theory. The population for this study was 5 Ghanaian SME manufacturing business leaders in the fruit industry who maintained their businesses longer than 5 years of operation. The data sources were semistructured face-to-face interviews, interview notes, and the organizations' manuals for standard operations. Data collected were transcribed, member checked, analytically coded, and analyzed using Yin's 5-stage method of qualitative data analysis. Four themes emerged: training and capacity building, the need for good equipment and good packaging, the availability of working capital, and the need for target marketing. The implications of this study for positive social change include lowering high unemployment, alleviating poverty, supporting community development, and enhancing economic growth in the country.