Multi-sector efforts to address the structural drivers of health inequities faced by racial and ethnic minority communities in the USA often ignore the potential of action by for-profit businesses, perhaps due to skepticism about the role of business in such efforts. However, given the need to harness diverse forms of capital to address structural harms, and recent calls to identify oft-ignored systemic pathways to health, we examined the role of business – specifically small, locally-owned businesses – in promoting community health and well-being. This study explored the role of small, locally owned businesses in community health, and local understandings of the value of such action, in the context of Roxbury, Massachusetts, a historically Black community with a substantial Latinx population. We conducted 20 semi-structured interviews between June and November 2021 with small business owners and staff, as well as leaders and staff from local non-profit organizations, anchor institutions, and one large business. Constructivist and critical perspectives guided the work. We used a team-based, thematic analysis approach; the team included residents and a small local business owner. Participants described pride in the neighborhood and emphasized small businesses’ contribution to long-term community well-being by investing social, cultural, human, and financial capital. Business owners saw their work as a way of giving back and did so in ways reflecting their deep understanding of community needs, aspirations, and identity. Public health efforts should engage pro-social small businesses embedded in marginalized communities, thereby supporting and amplifying businesses’ existing contributions to advancing equitable community health.