The percentage of full-time college students decreased by 7% in the United States between 2010 and 2018. Modern university leaders confront difficult decisions regarding their institutions' future because of financial challenges related to reduced tuition revenue. Grounded in the theory of diffusion of innovations and the balanced scorecard, the purpose of this qualitative multiple case study was to explore strategies leaders of small, nonprofit, private universities use to remain financially viable in a highly competitive environment. The participants included 6 university leaders from 2 small, private, nonprofit universities in the Midwest and Mid-Atlantic regions of the United States who implemented successful financial strategies. Data were collected by conducting semistructured interviews, examining organizational records, reviewing public data sources, and studying the institutions' websites. Through thematic analysis, 4 themes emerged: communication, strategic planning, being student focused, and fundraising and endowments. Key recommendations for small, private, nonprofit university leaders are developing communication processes, engaging in data-driven strategic planning, becoming student-focused, improving fundraising outcomes, and growing their endowment funds for long-term financial sustainability by being more creative innovative. The implications for positive social change include the potential to sustain small, nonprofit, private universities that impact local community members by providing employment and community outreach, contributing to economic and social growth. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]