Existing research posits that decision makers use specific cognitive frames to manage tensions in sustainability. However, we know less about how the cognitive frames of individuals at different levels in organization interact and what these interactions imply for managing sustainability tensions, such as in Bottom of the Pyramid (BOP) projects. To address this omission, we ask do organizational and project leaders differ in their understanding of tensions in a BOP project, and if so, how? We answer this question by drawing on a 5-year study of a BOP project of a global pharmaceutical company in India. In line with the existing research, we found three kinds of frames—paradoxical, business case, and business—held differently across organizational levels and over time. We also found that the shift in frames of both project and organizational leaders was mediated by the decision-making horizon. The initial divergence across organizational levels, seen in paradoxical and business frames, was mediated by long-term decision-making horizon. However, there was an eventual convergence toward business frames associated with the shift from long- to shorter-term decision-making horizons and one that led to the project’s closure. We contribute by proposing a dynamic model of cognitive frames in sustainability, where the research has either alluded to top-down or bottom-up understanding.