Despite the markedly increased foreign investment, East African economies remain characterized by low levels of investment and capital formation with high level of attrition amongst indigenous small and medium enterprises. While there is a high failure rate amongst these SMEs, some are beginning to turn the corner and are exhibiting signs of robustness, innovativeness and sustainability. Relying on narrative accounts of successful SMEs leaders in Kenya and Uganda obtained through interviews and focus group discussions, this study sought to construct an account of leadership practices and ascriptions of success for SMEs that had succeeded. The study identified eight leadership constructs characteristic of successful SME leaders in Kenya and Uganda grouped into visioning, building commitment, social capital, personal values, anticipation and resilience, resourcefulness, responsiveness, and entrepreneurial orientation. While these results, on the face value, are apparently not unique, it was in the nuances of the leadership practice that difference was made. In conclusion, the study highlights implications for these findings in relation to policy and leadership practice among SMEs.