Much as large companies do with innovation, would-be sustainability pioneers face three fundamental tensions: maintaining a long-term sustainability vision while delivering on short-term financial targets, introducing systemwide change while keeping people engaged at the local level, and being open to external collaboration while maintaining strong internal integration. As our pioneers have found with transformative innovations more generally, it is imperative to address these tensions intentionally. Doing so increases the likelihood that they will be able to successfully transition to sustainable business models. In this article we draw on our research to identify the specific practices companies can use to address these three fundamental challenges.