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This doctoral thesis examines how Sustainability-Oriented Innovations (SOIs) are emerging at small and medium-sized enterprises (SMEs) and how they can be managed. SOIs in the form of new products that lessen negative environmental impact, or even create a positive impact can play an important role, particularly at established SMEs who see business opportunities in sustainable development and consider a possible diversification into new sustainability markets. Whereas the extant literature discusses what SOIs are and why firms develop them, little is known about how they are developed. To enable firms to innovate for sustainability, it is essential to know more about the processes underlying SOI development, which are considered as very difficult, with many firms failing. Drawing on several academic papers and relying on qualitative research methods, the thesis uses the Fireworks model to examine how innovation processes unfold at established SMEs. The main contribution of the thesis is to advance the Fireworks model to the context of SOIs unfolding at SMEs. The findings reveal that SOIs unfold in an emergent, somewhat chaotic way, that duration and outcome are uncertain, that the overall journey is composed of multiple intertwined innovation paths, of which several will likely lead to setbacks. To manage this complex process, the thesis suggests to set four management foci: first, to create a dedicated organizational unit for exploration, second to create conditions allowing intelligent learning for efficient exploration, third to carry out in-depth investigation of the related technological innovation systems, and fourth to plan carefully the re-integration of the innovation into the core business for commercialization. This research contributes to the SOI literature by advancing the Fireworks model and thereby proposing a meta-model of how SOIs may dynamically unfold. Being both holistic and detailed, the model opens several avenues for future research. Finally, the research contributes to management practice by providing a heuristic to manage SOI development at SMEs.