Purpose: The study of successful transformational change processes in organizations has been limited. The purpose of this paper is to understand a change process and the type of change that occurred in a pharmaceutical company in Sweden 2005–2014. Design/methodology/approach: An interactive research design was used, and semi-structured interviews were conducted with 19 individuals, asking about their views on the change journey. Meetings and dialogue with leaders from the organization also took place. Observations from feedback meetings with leaders were included in the analysis. The results were analysed using a time-ordered display identifying key events, interpreted by a theoretical lens determining the type of change over a period of 10 years. Findings: This was a transformational change caused by external pressure, supported by visionary and transparent leadership, collaborative methods aiming at broad involvement and systemic understanding. The results indicated a 40 per cent increase in productivity and altered organizational design and culture. Sense-making activities, persistent adoption of quality improvement tools, dispersed power and sequential change activities underpinned the success. Practical implications: The results provide insight into the processes of transformational change. Change leaders were provided with knowledge, inspiration and insight when facing transformations. Social implications: Increased prevalence of transformational change calls for new organizational competencies and altered roles for leaders and employees. There is a need for new ways of developing competence and new recruitment policies for leaders. Originality/value: This case presents unique empirical evidence of a successful cultural transformation led by a leader using post-conventional principles. [ABSTRACT FROM AUTHOR]