More than 20% of small businesses that started in March 2018 failed within a year. Small business owners would benefit from strategies to identify and mitigate constraints from inception for business survival because business failure rates are higher among small businesses less than five years old. Grounded in the theory of constraints, this qualitative multiple case study aimed to explore strategies small business owners use to sustain beyond one year of operation. The participants included six small business owners in Georgia who successfully sustained their business for five years. Data were collected using semistructured interviews and analyzed using Yin's five-step data analysis approach. Three themes emerged: improving operational effectiveness, addressing marketing derivatives, and enhancing leadership competency. Key recommendations for new small business owners are utilizing bootstrapping techniques, offering customer-driven products and services, improving business networking, and strengthening leadership training. Positive social change implies the potential for local people's employment opportunities through business growth, leading to decreased poverty and improved living standards.