Abstract Background Prolonged sedentary behaviour (SB) poses health risks for office workers, especially in small-to-medium-sized enterprises (SMEs) often overlooked by current interventions. This abstract aims to report and examine solutions developed through co-creation for SB in SMEs. Methods Three Scottish SMEs, a construction company (n = 150) and two charities (n = 100; n = 30), participated in a co-creation process to create SME-specific actions on SB. Each formed an action group of employees (n = 9-12) as co-creators. The process consisted of between 6-8 workshops (each 1.5h) depending on the company, with workshops improved during the process based on formative reflection from co-creators. The co-creation workshops, facilitated by two researchers, initially involved jointly mapping the company’s current situation and building knowledge and awareness of SB. Further workshops focused on action planning, including brainstorming, feasibility, piloting, and final action(s) development. Following the co-creation of actions, researchers identified the Behaviour Change Techniques (BCTs) underlying the developed actions. Results Each company created a set of actions unique to them, e.g. standing desk promotion, a games room, and innovative meeting strategies. Regarding the BCTs, all companies included adding objects to the environment, physical restructuring, prompts or cues, and addressing health or social and environmental consequences. Additionally, they all incorporated ‘step challenges’ with behaviour self-monitoring and feedback techniques. Two companies offered incentives or rewards; one emphasized role modelling, and another included social support. Conclusions The three companies created tailored actions through the co-creation process. While there were some commonalities, the differences in actions and BCTs among companies underscore the necessity for solutions tailored to the organizational context and the importance of involving employees in creating solutions. Key messages • Co-created actions to combat SB used diverse strategies, emphasising a multifaceted approach to address workplace SB. • Variability among SMEs’ co-created actions underscores the importance of stakeholder involvement to tailor solutions to organisational contexts.