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Analyzing qualitative case-study data from two emerging market multinational corporations (MNCs) from the Indian pharmaceutical industry, we develop two theoretical frameworks based on goal-setting and cognitive evaluation theories along with indigenous Indian management theories, including the principles of Ayurveda for analyzing performance management systems in an indigenous and modern pharmaceutical MNC. Data were analyzed from multiple data sources, such as interviews, nonparticipant observation, multiple site visits, organizational documents, policies, client testimonials, and publically available information through the website and annual reports. The indigenous firm offered a holistic approach to managing multiple stakeholders. Its overarching performance goal focused on all stakeholders collectively contributing to the patient' and others' holistic well-being. All employees' and stakeholders' unified and singular efforts dovetailed to achieve physical, mental, emotional, spiritual, and environmental well-being as a proxy for performance. Organizational values, culture, and contextual influences of informal learning, empowerment, and task variability helped achieve its overarching goals. The Western pharmaceutical firm focused on atomistic, granulated, and an objective way of assessing and evaluating performance, wherein cost-effectiveness, innovation, and high-performance were vital performance outcomes. Performance coaching and task invariability adversely affected individual outcomes. Implications for research and practice are discussed.