We investigated managers’ work and behaviour patterns in profitable growth small- and medium-sized Swedish companies, and considered how these patterns might be associated with good health outcomes. Specifically, we looked at hours worked by managers, proportion of time spent on working activities, and leadership behaviour orientation. We used a quantitative cross-sectional design and collected data via a standardized questionnaire that was answered by 133 top managers. The data were analyzed with descriptive statistics, linear regression, and compositional data analysis. Our results indicate that the managers worked long hours, which is a health risk both for them as individuals and for their organizations, but also that they engaged in work practices and leadership behaviours that were favourable for organizational health and for their employees. The managers spent a high proportion of their time in touring, which could be beneficial to organizational health, and exercised active leadership through behaviours that contribute to both employee health and company effectiveness. Comparing our results to other studies, we can observe that patterns of managers’ time use differ between small and large companies, confirming that the size of the firm is an important determinant of managerial work.