The development and scaling of orange-fleshed sweetpotato (OFSP) during the past 25 years is a case study of a disruptive innovation to address a pressing need – the high levels of vitamin A deficiency among children under five years of age in sub-Saharan Africa. When the innovation was introduced consumers strongly preferred white or yellow-fleshed sweetpotato, so it was necessary to create a demand to respond to that need. This was at odds with the breeding strategy of responding to consumers’ demands. Additional elements of the innovation package include seed systems and nutrition education to create the awareness amongst consumers of the significant health benefits of OFSP. Complementary innovation is required in promotion and advocacy to ensure a supportive institutional environment. Four dimensions-- technical, organizational, leadership, and institutional environment-- are explored across five distinct phases of the innovation process, from the emergence of the innovative idea (1991–1996) through scaling phase in 15 countries under a major institutional innovation (2015-mid-2019), the Sweetpotato for Profit and Health Initiative (SPHI). Systematically gathering evidence of nutritional impact and ability to scale cost-effectively was requisite for obtaining support for further development and diffusion of the crop. Positive findings from a major study coincided with a major change in the institutional environment which placed agriculture and nutrition at the forefront of the development agenda, resulting in an inflection point in both research and diffusion investment. The role of committed leadership during all phases was critical for success, but particularly during the first decade of limited support in a challenging institutional environment. The most critical technical achievement underpinning scaling was moving from 2 to 13 African countries having local breeding programs. Evidence is presented that adapted, well performing varieties which consumers prefer is the foundation for successful scaling to occur. Building a cadre of within country and regional advocates was critical for getting sustained commitment and local buy-in to the concept of biofortification by regional bodies and governments, which in turn built within country ownership and the willingness of donors to invest. The SPHI united diverse organizations under a common vision with a simple metric--- the number of households reached with improved varieties of sweetpotato. Since 2009, 6.2 million households were reached by July 2019 in 15 SSA countries. Much more remains to be done. Advocacy efforts led to the integration of nutritious foods into many national and regional policies, setting the stage for further investment.