Background: Small-scale enterprises (SSEs) are regarded as important contributors to economic development. However, there is a limited understanding about the importance of the psychosocial working conditions, the work-life balance, health and well-being in these enterprises. Research on psychosocial working conditions in SSEs is polarized and shows contradictory results, and it is often stated that SSEs have trouble with workplace health and disability management processes due to their limited resources, and lack of support from human resource consultants. According to the Luxemburg Declaration of Workplace Health Promotion health in the workplace can be achieved by monitoring a wide range of factors; e.g. management principles, organizational culture, involvement of all the workforce and balance between job demands and control in work. ‘Disability Management’ is an approach which goes beyond traditional vocational rehabilitation due to its focus on prevention of injury as well as return to work assistance following injury, and the importance of using the workplace for interventions at all levels of the organization. Purpose and method: The overall aim of the study is, from a leader perspective, to explore small scale enterprises (SSEs) conditions for managing health promoting workplaces. This study analyzes data from interviews with leaders in 18 small scale enterprises in the middle part of Norway and Sweden. The methodology used to study conditions to create health promoting workplaces was based on a step-wise inductive method. Findings: The analyses revealed two main categories as important for creating health-promoting workplaces: conditions for managing workplace health promotion and conditions for a health promoting leadership. Each category contained several sub-themes that were related to solidarity and flexibility among employees, self-steered task management, good and joyful working conditions and managing leadership role essential for developing a healthy workplace. Conclusions: The leader’s view of health promoting workplaces point at great consciousness and maturity in their approach to create a health-promotive workplace. The premises for healthy work conditions in small-scale enterprises seem to be favorable despite obstacles and limited resources available.