Aravind Eye Care System (AECS or Aravind), Madurai, Tamil Nadu, India, has been a hugely successful set of related, vertically integrated organizations that provides eye care to several hundreds of thousands of people each year. The demise of Dr. Govindappa Venkataswamy (Dr. V), its founder, in 2006 resulted in a close family member, Dr. Namperumalswamy (Dr. Nam), a retina care specialist in his own right, taking up the mantle of leadership of the institution. As he settled down to leading Aravind and setting a direction for the organization over the next  decade, he had to contend with a changing environment, where cataract surgeries, that had been the signature offering of Aravind, had become commoditized, with many eye hospitals across the country offering these services. There were many other significant changes in the environment, including increasing prevalence of new forms of eye diseases caused by a host of factors such as changing lifestyles. The number of family and non-family professionals and other employees in the Aravind system had been growing rapidly. The new leadership had to confront these and many other challenges. Aravind was at the crossroads, as it embarked on a journey, seeking to step outside the shadow of a giant (Dr. V). Specifically, the case raises a host of questions for the (new) senior leadership of Aravind. challenge for the new leader, Dr. Nam, was how to continue to instill the spirit of service and corporate social responsibility, which were the cornerstones of the organization’s very existence during its first three decades of existence. Should the leader signal a relatively low-risk period of consolidation or encourage risk-taking and rapid growth to leverage new opportunities available to the organization? At the same time, how should the organization grapple with the multiple challenges that now confronted it? It was not going to easy for new leader to step into the role of a giant that Dr. V was.