The pursuit of growth is a key endeavor of all types of firms, but it is particularly important for SMEs. From a managerial perspective, growing SMEs face a wide range of challenges; this study proposes a broad framework that emphasizes not only the various types of managerial challenges, but also the importance of taking a balanced, broad approach to facing them. In a qualitative study of 44 Swedish SMEs, the researchers identify, map, and aggregate distinct challenges to SME growth, proposing three overarching themes - business model, leadership, and people. Multiple lower-level categories and individual challenges make up each of these themes suggesting that firms that seek to excel in growth should be aware of and manage all three themes in a balanced manner. This research provides insights into each theme and potential consequences for SMEs; it also offers an overarching, integrative perspective on SME growth challenges opening future research avenues.