The purpose of this intrinsic qualitative study was to examine and understand how leaders at a startup biotechnology organization successfully established a positive culture and high organizational performance during a period of rapid growth and transition. In order to achieve this, two research questions were established as the underpinning for this investigation: a) How did leaders at a startup biotechnology organization successfully create and sustain a positive organizational culture during a period of rapid growth? and b) How did leaders at a startup biotechnology organization connect their culture to their organizational performance? Data included nine semi-structured, in-depth open-ended question interviews, one off-site focus group that included seven CAP Pharmaceuticals Emerging Leader Program members, eight field observations, field notes, and private and public CAP documents. The data was collected and analyzed by employing general inductive analysis, constant comparison, and multiple data coding strategies. The demographics of the study participants represented a diverse group of CAP leaders and emerging leaders, divided evenly across gender and positions within the study site. Additional selection criteria included full-time employment at CAP, holding a leadership role, and contributing to development of CAP's company culture. Findings revealed that throughout the data collection process, CAP leaders used the term 'people' when referring to their employees. Because the term 'people' conveys a more equal relationship than 'employees,' this finding conveys an aspect of CAP culture that was not initially considered. Other times during the interviews, employees were referred to as "family". After analysis of the data, two main themes emerged in relation to each research question. The themes aligning with each research question focused on the steps the leaders took in creating and sustaining a positive organizational culture during a period of rapid growth. For the second 3 research question, the emerging themes of maximizing employee potential and the importance of communication in order to connect their culture to their organizational performance were observed. From these findings, three cohesive conclusions were drawn: (a) CAP leaders believed that building multi-leveled trust was a key to creation of positive culture, (b) A positive culture enabled risk taking and learning from mistakes important for innovation, and (c) CAP leaders were flexible enough to make changes in response to employee feedback and concerns. The focus on positive culture included the idea of making intentional decisions, developing and encouraging trust, and listening to people. CAP leaders learned that being flexible and nimble in response to organizational challenges, as well as in response to employee feedback, could be embraced and utilized as an organizational strength.