This chapter offers a comprehensive literature review on business model innovation (BMI) sustainability and an extension of related research works to the family business field. It explores the conditions under which family businesses differ from non-family businesses and from each other across generations in achieving BMI sustainability. It argues that the differences lie in both external and internal factors at the intersection of the business, family and environment. A series of hypotheses emerge on the relation between BMI sustainability and the new technologies and digitalization, the institutional context, and the family’s emotional attachment to its business(es). A research agenda and methodological propositions are presented towards a further exploration of sustainable business model innovation in family business along with suggestions for practical implications.