Sustaining businesses has become challenging nowadays. Market competition and failure to respond to growing demand are forms of risks that may range from lost opportunities to business closure. Managers need to develop leadership styles and implement business excellence to sustain operations. Grounded in organizational theory, the purpose of this chapter's mixed method is to examine if leadership styles and business excellence may enable firms' business sustainability. Data were gathered from the United States 128 construction business leaders through the multifactor leadership questionnaire and analyzed using multiple linear regression, multiple case study semi-structured interviews with two business leaders, and a review of previous literature. A key recommendation for business managers is to develop transformational leadership attributes and implement business excellence to sustain their business. Transformational leadership style and business excellence enable business sustainability by improving performance and positively contributing to communities' stability and growth.