Resource-poor organizations serve a significant portion of emerging markets’ healthcare industries. Such organizations engage in transformative services. However, given emerging markets’ ever-changing dynamics, it is unclear whether transformative services suffice for such organizations to move towards economic and social sustainability. We present two studies undertaken in the context of missionary hospitals in India. Study 1 identifies that hospitals rely on innovations in transformative services, driven by the co-creation of knowledge by various stakeholders, to remain socially and economically sustainable. Study 2 develops and tests hypotheses using data from 183 hospitals, showing that employee voice, community engagement, and diversity of organizational expertise increase innovation in transformative services at a decreasing rate, while resource munificence and commercialization emphasis moderate the antecedents’ effects. Post hoc analyses show that innovation in transformative services positively affect economic and social sustainability, and that awareness creating efforts moderate these relationships. More broadly, innovations in transformative services are critical for emerging markets’ resource-poor organizations’ economic and social sustainability.