The role of (entrepreneurial) universities as change agents in regional economic development has been highlighted previously, but how they can drive regional sustainable development in developing countries has been largely neglected to date. Using qualitative methods and building upon institutional perspectives of sustainable change, we show how being confronted with adverse poverty and pollution in local contexts can drive an entrepreneurial university to develop a sustainability vision that accordingly becomes the driver of institutional change. We demonstrate how local campus leadership, a holistic teaching and research programme, and student involvement can have significant local effects over the short term. However, we also show how li...