Business is increasingly seen as central to international development, given the power of companies within markets and other related systems that affect the lives of the poor. However, there is a rising sense that these approaches have generally not achieved substantial impact over the long term or at large scales. Based on a multi-level perspective of systemic change, this article explores evidence from nine case studies of pro-poor business initiatives, to examine their potential to go beyond individual company value chains and drive positive shifts in broader market systems. The analysis suggests that initiatives based around existing company value chains are less likely to be systemic than those involving the creation of new companies or platforms of actors from different parts of society. The article concludes with some implications for development agents working with business.