["Business Strategy and the Environment, EarlyView. ", "\nABSTRACT\nThis study examines the relationship between sustainable leadership (SL) and organizational sustainable performance through green knowledge sharing (GKS). Drawing on the Natural Resource‐Based View (NRBV) and stakeholder theory, this study examines the moderating roles of organizational commitment and family ownership in the relationships among SL, GKS, and sustainable performance in Chinese healthcare SMEs. Data were collected via questionnaire surveys from 126 CEOs of healthcare SMEs and analyzed using structural equation modeling (SEM) in SmartPLS 4.0. The results show that SL positively influences environmental, financial, and social performance. GKS positively mediates the relationship between SL and environmental and social performance. Organizational commitment negatively moderates the relationship between SL and GKS, while family ownership strengthens the link between GKS and financial performance. These findings provide policymakers and family business owners with valuable insights for designing strategies to enhance sustainable performance in the healthcare sector. The study contributes to the literature by explaining how and when SL influences organizational sustainability in healthcare SMEs. The theoretical and practical implications were provided.\n"]