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This chapter describes practical lessons for leading transformational innovation in industrial firms. These lessons result from theory-building empirical research based on published studies and the authors’ personal observations. These latter are the results of interviews with over 100 senior managers. The research also discriminates between the capabilities for leading core, adjacent and transformational innovations. In practice, each form requires different leadership and skills to ensure success. In the past, firms that use this approach have been described as ambidextrous. However, this oversimplifies the situation rather than considering the continuum of innovation approaches within a firm necessary to ensure long-term sustainability. This is because firms must innovate long-term, deliver ongoing core innovation in their existing portfolio, and evolve their value propositions and business models through adjacent innovation.